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Observational Study
. 2020 Dec 15;147(12):3424-3430.
doi: 10.1002/ijc.33179. Epub 2020 Jul 11.

Cancer-specific ischemic complications in elderly patients with atrial fibrillation: Data from the prospective ATHERO-AF study

Daniele Pastori  1 , Danilo Menichelli  1 , Tommaso Bucci  2 , Francesco Violi  1   3 , Pasquale Pignatelli  1   3 ; ATHERO-AF study group
Affiliations
Observational Study

Cancer-specific ischemic complications in elderly patients with atrial fibrillation: Data from the prospective ATHERO-AF study

Daniele Pastori et al. Int J Cancer. .

Abstract

Cancer may complicate the clinical course of nonvalvular atrial fibrillation (AF) but its association with cardiovascular events (CVEs) remains unclear. We performed a prospective cohort study including 2092 consecutive AF patients on vitamin K antagonists. Principal endpoint was the occurrence of CVEs including fatal/nonfatal myocardial infarction and ischemic stroke/transient ischemic attack and cardiovascular death. Secondary endpoints were major adverse cardiac events (MACEs) and thromboembolism (TE). Mean age was 73.7 ± 9.1 years and 42.1% were women; 367 (17.5%) patients had cancer: 21% gastrointestinal (GI), 10% respiratory, 28% genitourinary and 41% had other localization. Cancer patients were older but with similar comorbidities than those without. During a mean of 35.9 months, 203 CVEs occurred (incidence rate [IR] = 3.24 per 100 patient-years): 133 MACEs (IR = 2.12 per 100 patient-years) and 70 TE (IR = 1.12 per 100 patient-years). Multivariable Cox proportional hazards regression analysis showed an association between GI cancer and MACE occurrence (hazard ratio [HR] = 3.22, 95% confidence interval [CI] = 1.59-6.52, P = .001) and between respiratory cancer and TE (HR = 3.37, 95% CI = 1.30-8.75, P = .013). These associations were confirmed at competing risk analysis. In conclusion, AF patients with cancer have specific vascular outcomes according to cancer site, as indicated by the higher risk of MACE and TE in patients with gastrointestinal and respiratory cancer, respectively.

Keywords: atrial fibrillation; cancer; cardiovascular events; ischemic stroke; major adverse cardiac events.

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References

REFERENCES

    1. Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27:949-953.
    1. Menichelli D, Ettorre E, Pani A, Violi F, Pignatelli P, Pastori D. Update and unmet needs on the use of nonvitamin K oral anticoagulants for stroke prevention in patients with atrial fibrillation. Curr Probl Cardiol. 2019;100410.
    1. Hu YF, Liu CJ, Chang PM, et al. Incident thromboembolism and heart failure associated with new-onset atrial fibrillation in cancer patients. Int J Cardiol. 2013;165:355-357.
    1. Violi F, Soliman EZ, Pignatelli P, Pastori D. Atrial fibrillation and myocardial infarction: a systematic review and appraisal of pathophysiologic mechanisms. J Am Heart Assoc. 2016;5:e003347.
    1. Gomez-Outes A, Lagunar-Ruiz J, Terleira-Fernandez AI, Calvo-Rojas G, Suarez-Gea ML, Vargas-Castrillon E. Causes of death in anticoagulated patients with atrial fibrillation. J Am Coll Cardiol. 2016;68:2508-2521.

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