Steven Soo

All Publications

• Impact of Statin Use on Cardiovascular and Hematologic Outcomes Among Patients with Myeloproliferative Neoplasms. Blood advances Leiva, O., Soo, S., Liu, O. C., You, V., Palmer, A. S., Kahla, J. A., Murtaza, Y., Odenike, O., Patel, A. A., DeCara, J., Dubielecka, P. M., Petersen, M., Lee, M. H., How, J., Hobbs, G. S. 2026

  Abstract

  Myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), are chronic myeloid neoplasms associated with increased risk of cardiovascular disease (CVD). Statins are a common group of cholesterol-lower medications recommended for the primary and secondary prevention of CVD, including arterial thrombotic events. Emerging evidence suggests that statins may reduce the risk of developing MPNs and their use may be associated with improved survival. However, statins impact on cardiovascular and hematologic outcomes among patients with MPNs remains uncharacterized. We conducted a multicenter retrospective cohort study of patients with MPNs who had at least one transthoracic echocardiogram (TTE) from 2010 to 2024. Inverse-probability treatment weighting (IPTW) competing-risk regression analysis was performed to assess the association between statin use at time of index TTE on major adverse cardiovascular events (MACE), MPN disease progression, and all-cause death. MPN patients were analyzed as a whole and separately by type (ET or PV and MF). A total of 669 patients were included, 43.9% were on statin use, 50.5% were female, 83.9% were White, 78.8% had JAK2 driver mutation, and 72.9% had class I guideline indication for statin therapy. There were 267 (39.9%) PV, 234 (35.0%) ET, and 168 (25.1%) MF patients. After IPTW, statin use was associated with lower risk of MACE (SHR 0.83, 95% CI 0.70 - 0.98) but not MPN disease progression (SHR 0.96, 95% CI 0.72 - 1.29) or all-cause death (HR 1.04, 95% CI 0.87 - 1.24). Among patients with ET or PV, statin use was associated with lower risk of MACE (SHR 0.78, 95% CI 0.64 - 0.95) but not MPN progression (SHR 1.03, 95% CI 0.74 - 1.44) or all-cause death (HR 0.85, 95% CI 0.68 - 1.06). Among patients with MF, there was no difference in MACE, leukemia progression, or all-cause death. Among patients with MPNs who underwent TTE, statin use was associated with lower risk of MACE, particularly among patients with ET or PV. However, there was no association between statin use and all-cause death or MPN disease progression. Statin therapy is underutilized in this patient population. Further studies are needed to explore the utility of statin therapy in patients with MPN and identify patients who would benefit most from statin therapy.

  View details for DOI 10.1182/bloodadvances.2025018724

  View details for PubMedID 41499780

• Characterization and Prognostic Implications of Pulmonary Hypertension on Right Heart Catheterization Among Patients with Myeloproliferative Neoplasms Leiva, O., Soo, S., Liu, O., Kahla, J., Murtaza, Y., You, V., Palmer, A., Patel, A., Belkin, M., Swat, S., Gozdecki, L., Kanwar, M., Odenike, O., How, J., Hobbs, G. LIPPINCOTT WILLIAMS & WILKINS. 2025

  View details for DOI 10.1161/circ.152.suppl_3.4372348

  View details for Web of Science ID 001613798200031

• Characterization and prognostic implication of pulmonary hypertension among patients with myeloproliferative neoplasms. Haematologica Leiva, O., Soo, S., Liu, O., Smilowitz, N. R., Reynolds, H., Shah, B., Bernard, S., How, J., Lee, M. H., Hobbs, G. 2025; 110 (10): 2388-2399

  Abstract

  Pulmonary hypertension (PH) is a frequent complication of Philadelphia-negative myeloproliferative neoplasms (MPN), including essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF). However, its prognostic significance is understudied. We, therefore, aimed to evaluate the effect of PH identified by echocardiography on the risk of progression to secondary MF or acute leukemia in MPN patients. We conducted a multicenter, retrospective cohort study of MPN patients with ≥1 echocardiogram from 2010-2023. PH was defined as pulmonary artery systolic pressure ≥40 mmHg. Outcomes were progression to secondary MF or leukemia, major adverse cardiovascular events (MACE) and allcause mortality. Multivariable Fine-Gray competing-risk regression analysis was used to estimate subdistribution hazard ratios (SHR) of hematologic progression and MACE. Five hundred and fifty-five patients were included (42.7% with PV, 41.1% with ET, 16.2% with MF) or whom 195 (35.1%) had PH. Over a median follow-up period of 51.2 months, PH was associated with an increased risk of secondary MF progression (adjusted SHR [aSHR], 95% confidence interval [95% CI]: 1.25-4.59), leukemia progression (aSHR=3.06, 95% CI: 1.13-8.25), and MACE (aSHR=1.59, 95% CI: 1.01-2.49) but not all-cause death (adjusted hazard ratio=1.48, 95% CI: 0.96-2.26). In patients with PH, absence of left heart disease was associated with a higher risk of secondary MF progression among patients with ET or PV (aSHR=2.76, 95% CI: 1.19-6.38) and leukemia progression among patients with MF (aSHR=7.18, 95% CI: 1.59-32.46). Prospective studies are needed to assess the role of echocardiography in MPN-specific prognostication.

  View details for DOI 10.3324/haematol.2025.287497

  View details for PubMedID 40371905

  View details for PubMedCentralID PMC12485355

• Impact of Echocardiographic Probability of Pulmonary Hypertension on Prognosis and Outcomes Among Patients With Myeloproliferative Neoplasms. Circulation. Cardiovascular imaging Leiva, O., Soo, S., Smilowitz, N. R., Reynolds, H., Shah, B., Bernard, S., How, J., Lee, M. H., Hobbs, G. 2025; 18 (8): e017986

  Abstract

  Myeloproliferative neoplasms (MPN) are a group of chronic leukemias that are associated with pulmonary hypertension (PH), which has been associated with increased risk adverse outcomes. The echocardiographic characterization of PH in MPN has not been reported, and the prognostic significance of PH among patients with MPN remains unclear.This was a multicenter, retrospective cohort study of patients with MPN with ≥1 echocardiogram from 2010 to 2023. The echocardiographic probability of PH was determined according to the guidelines. The outcomes were hematologic progression and major adverse cardiovascular events. Exploratory analysis included outcomes among patients with right heart catheterization after the first echocardiogram, with PH defined as mean pulmonary artery pressure of >20 mm Hg. Multivariable Fine-Gray competing risk regression was used to estimate the subhazard ratio of hematologic progression and major adverse cardiovascular events.Five hundred fifty-five patients were included and 237 (42.7%) had an intermediate or high probability of PH on echocardiography. Over a median follow-up period of 51.2 months (interquartile range, 29.5-79.8), it was observed that echocardiographic probability of PH was associated with increased risk of hematologic progression (adjusted subhazard ratio, 1.92 [95% CI, 1.09-3.39]) and major adverse cardiovascular events (adjusted subhazard ratio, 1.66 [95% CI, 1.04-2.66]) but not all-cause death (adjusted hazard ratio, 1.51 [95% CI, 0.98-2.32]). Among patients with right heart catheterization (n=61), PH was present in 51 (83.6%) patients and was associated with a higher risk of hematologic progression (29.4% versus 0%; P=0.048).Among patients with MPN, echocardiographic probability of PH was associated with an increased risk of hematologic progression. Prospective studies are needed to assess the optimal use of echocardiography on MPN-specific prognostication.

  View details for DOI 10.1161/CIRCIMAGING.124.017986

  View details for PubMedID 40492300

• Outcomes of patients with cancer admitted with heart failure-associated cardiogenic shock. European heart journal. Acute cardiovascular care Liu, O., Soo, S., Bloom, M., Alvarez-Cardona, J., Katz, J. N., Cheng, R. K., Yang, E. H., Leiva, O. 2025; 14 (6): 318-326

  Abstract

  Acute decompensated heart failure (HF) can progress to cardiogenic shock, and patients with cancer are at an increased risk of HF compared with patients without cancer. However, limited data exist on outcomes of patients admitted for HF-related cardiogenic shock (HF-CS) with cancer vs. without cancer.Adult patients admitted for HF-CS between 2014 and 2020 were identified using the National Readmission Database. Propensity score matching (PSM) was used to match 1 patient with cancer to 10 patients without cancer. Primary outcomes were in-hospital death, major bleeding, and thrombotic complications. Exploratory outcomes were 90-day readmission rates among patients who survived initial hospitalization. Temporal trends were also explored. Of the 137 316 admissions for HF-CS, 7306 (5.3%) had active cancer. After PSM, patients with cancer had increased odds of in-hospital death [odds ratio (OR) 1.12, 95% confidence interval (CI) 1.06-1.18], thrombotic complications (OR 1.12, 95% CI 1.03-1.21), and major bleeding (OR 1.23, 95% CI 1.17-1.31) compared with patients without cancer, with risks differing by cancer type. In exploratory analyses, rates of readmission were similar for patients with and without cancer. From 2014 to 2020, patients with cancer had no significant change in in-hospital mortality (Ptrend = 0.43), while patients without cancer had decreased mortality over time (Ptrend < 0.001).Among patients admitted for HF-CS, patients with cancer are at increased risk of in-hospital death, thrombotic complications, and major bleeding compared with patients without cancer. Future studies are needed to guide nuanced evaluation and management of this population to improve outcomes.

  View details for DOI 10.1093/ehjacc/zuaf027

  View details for PubMedID 39992871

• Choosing Intra-aortic Balloon Pump Or Impella Support To Optimize Hemodynamics For Patients Presenting With Acute Coronary Syndrome Journal of Cardiac Failure Sandher, S., Alam, A., Soo, S. 2025; 31 (1)

  View details for DOI 10.1016/j.cardfail.2024.10.268

• Divergent Early Immune Trajectories in Dual-Organ Heart Transplantation: Insights from ImmuKnow Monitoring American Journal of Transplantation Phillips, K., Golob, S., Moussa, M., Rana, M., Singh, P., Soo, S., Grossi, E., Rao, S., Reyentovich, A., Wayda, B., Moazami, N., Goldberg, R., Alam, A. 2025; 25 (8)

  View details for DOI 10.1016/j.ajt.2025.07.746

• Impact of Donor and Recipient Characteristics on Post-Transplant ImmuKnow and AlloMap Following Heart Transplantation American Journal of Transplantation Singh, P., Golob, S., Phillips, K., Moussa, M., Rana, M., Soo, S., Rao, S., Reyentovich, A., Moazami, N., Goldberg, R., Alam, A. 2025; 25 (8)

  View details for DOI 10.1016/j.ajt.2025.07.743

• Association of ImmuKnow with Post-Transplant Coronary Artery Vasculopathy American Journal of Transplantation Golob, S., Phillips, K., Moussa, M., Rana, M., Singh, P., Soo, S., Grossi, E., Rao, S., Reyentovich, A., Moazami, N., Wayda, B., Goldberg, R., Alam, A. 2025; 25 (8)

  View details for DOI 10.1016/j.ajt.2025.07.353

• Prognostic Implications of Pulmonary Hypertension in Myeloproliferative Neoplasms and Predictors of Hematologic Progression Leiva, O., Soo, S., Smilowitz, N., Reynolds, H., Shah, B., Bernard, S., Lee, M., How, C., Hobbs, G. S. ELSEVIER. 2024: 248

  View details for DOI 10.1182/blood-2024-199120

  View details for Web of Science ID 001414317000046

• Incidence, Risk Factors, and Prognostic Implications of Heart Failure Hospitalizations Among Patients with Myeloproliferative Neoplasms Leiva, O., Soo, S., Smilowitz, N., Reynolds, H., Shah, B., Bernard, S., Lee, M., How, C., Hobbs, G. S. ELSEVIER. 2024: 3188-3189

  View details for DOI 10.1182/blood-2024-207586

  View details for Web of Science ID 001412581600044

• Cancer Therapy-Associated Pulmonary Hypertension and Right Ventricular Dysfunction: Etiologies and Prognostic Implications. Reviews in cardiovascular medicine Leiva, O., Beaty, W., Soo, S., Agarwal, M. A., Yang, E. H. 2024; 25 (3): 87

  Abstract

  Advances in cancer therapies have improved oncologic outcomes but can potentially expose patients to risk of cardiovascular toxicity. While left ventricular (LV) dysfunction is a well-known cardiotoxicity of cancer therapy. Pulmonary hypertension (PH) and right ventricular (RV) dysfunction are seen with several cancer therapies, including alkylating agents, tyrosine kinase inhibitors (TKIs), and immunotherapy, and are associated with significant morbidity and mortality. Awareness and recognition of cancer therapy-associated PH and RV dysfunction is critical to identify underlying etiologies and institute the appropriate therapy. However, gaps exist in the current literature on the epidemiology of PH and RV dysfunction in cancer, underlying pathophysiology and optimal management strategies.

  View details for DOI 10.31083/j.rcm2503087

  View details for PubMedID 39076943

  View details for PubMedCentralID PMC11263834

• STEMI IN A YOUNG PATIENT WITH ANTIPHOSPHOLIPID SYNDROME Journal of the American College of Cardiology Soo, S., Xia, J., Kim, S., Papadakos, S. 2024; 83

  View details for DOI 10.1016/S0735-1097%2824%2905327-0

• Association of Elevated Pulmonary Artery Systolic Pressure with Hematologic Progression in Myeloproliferative Neoplasms Journal of Clinical Oncology Leiva, O., Soo, S., How, C., Smilowitz, N., Shah, B., Reynolds, H., Hobbs, G., Bernard, S. 2024; 42

  View details for DOI 10.1200/JCO.2024.42.16_suppl.6575

• Quality Improvement Project to Increase the HPV Vaccination Rates of 13 year old Patients at a Pediatric Clinic Pediatric Academic Societies (PAS) Soo, S., Asuncion, A., O'Keefe, P. 2022
• Novel approaches in the post-tracheostomy care of the COVID-19 patient Critical Care Innovations Rai, A., Chang, A., Soo, S., Thomas, J., Ackerman, J., Mitzman, B., Bender, M. 2020; 3 (3)

  View details for DOI 10.32114/cci.2020.3.3.13.19