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- Title
Czy pacjenci onkologiczni mają inny fenotyp migotania przedsionków?
- Authors
Hawryszko, Maja; Sławiński, Grzegorz; Lewicka, Ewa; Młyński, Mikołaj; Daniłowicz-Szymanowicz, Ludmiła; Pusz-Bulas, Weronika; Macuk, Patryk; Wiśniewska, Kalina
- Abstract
OBJECTIVES Atrial fibrillation (AF) is the most common arrhythmia in the general population (2%-4%) and it is much more common in cancer patients (2%-16%). AIM OF THE STUDY This single center, retrospective study aimed to compare a clinical phenotype of two groups of AF patients: with cancer (study group) and without cancer (control group). MATERIAL AND METHODS The study group consisted of consecutive patients diagnosed with AF who were consulted in the Outpatient Cardio- -Oncology Clinic between January 1 and December 31, 2022. They were matched in terms of age and gender with subsequent patients with AF treated in the Outpatient Cardiology Clinic at the same time. Statistical analysis included demographic data, comorbidities, cardiovascular risk factors (CVRFs) such as dyslipidemia, arterial hypertension, diabetes, obesity, current or previous smoking, medications used, laboratory test RESULTS, echocardiographic parameters and Holter ECG monitoring results. RESULTS The study group consisted of 110 patients in the mean age of 70 ± 10 years, 56% men. There were 107 patients in the control group (mean age 70 ± 8 years, 58% men). The Charlson Index was higher in cancer patients (median 4 vs. 2 points; P <0.001). However, there were no differences between the groups in the incidence of coronary artery disease (28 vs. 37 patients; P = 0.13), and the number of patients with >2 CVRFs (81.8% vs. 76.6%; P = 0.35) or ≥3 CVRFs (47.3% vs. 45.8%; P = 0.83). Cancer patients showed higher left ventricular ejection fraction: median 57% (50%-60%) vs. 52% (42%-60%); P = 0.026, smaller left atrial (LA) diameter (43 ± 6 mm vs. 47 ± 7 mm; P = 0.015) and LA volume (90 ± 30 ml vs. 113 ± 66 ml; P = 0.04). The number of patients with permanent AF did not differ between the groups (30 vs. 25 patients; P = 0.53). However, cancer patients were less likely to be referred for electrical cardioversion (21 vs. 37 patients; P = 0.01) and pulmonary vein isolation (3 vs. 23 patients; P <0.001). Also antiarrhythmic drugs (except beta-blockers) were less frequently used in the study group (16 vs. 47 patients; P <0.001). Anticoagulation was administered in 95 vs. 86 patients (P = 0.046), and low-molecular-weight heparins were used more often in cancer patients (17 vs. 1 patients; P = 0.001). There were no differences between the groups regarding the incidence of LA appendage thrombi (1 vs. 5 patients; P = 0.09) or major bleedings (9 vs. 4 patients; P = 0. 168). CONCLUSION Cancer patients diagnosed with AF present a different clinical phenotype when compared to cancer-free patients. This may indicate a different pathophysiology of this arrhythmia in cancer patients. Intensive CVRF control in these patients may be beneficial in reducing the risk of AF and its recurrence.
- Subjects
POLAND; ATRIAL fibrillation diagnosis; CANCER patients; CONFERENCES &; conventions; PHENOTYPES
- Publication
Polish Heart Journal / Kardiologia Polska, 2024, Vol 82, p16
- ISSN
0022-9032
- Publication type
Article