TY - JOUR
T1 - Impact of malignancy on outcomes in European patients with atrial fibrillation
T2 - A report from the ESC-EHRA EURObservational Research Programme in Atrial Fibrillation General Long-Term Registry
AU - Malavasi, Vincenzo L.
AU - Vitolo, Marco
AU - Proietti, Marco
AU - Diemberger, Igor
AU - Fauchier, Laurent
AU - Marin, Francisco
AU - Nabauer, Michael
AU - Potpara, Tatjana S.
AU - Dan, Gheorghe-Andrei
AU - Kalarus, Zbigniew
AU - Tavazzi, Luigi
AU - Maggioni, Aldo Pietro
AU - Lane, Deirdre A.
AU - Lip, Gregory Y. H.
AU - Boriani, Giuseppe
AU - ESC-EHRA EORP-AF Long-Term General Registry Investigators
A2 - Joensen, Albert Marni
A2 - Gammelmark, Anders
A2 - Rasmussen, Lars Hvilsted
A2 - Dinesen, Pia Thisted
A2 - Riahi, Sam
A2 - Venø, Stine Krogh
A2 - Sørensen, Bodil Ginnerup
A2 - Korsgaard, Anne Marie
A2 - Andersen , Karen Petrea
A2 - Hellum, Camilla Fragtrup
N1 - © 2022 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
PY - 2022/7
Y1 - 2022/7
N2 - BACKGROUND: The management of patients with atrial fibrillation (AF) and malignancy is challenging given the paucity of evidence supporting their appropriate clinical management. PURPOSE: To evaluate the outcomes of patients with active or prior malignancy in a contemporary cohort of European AF patients. METHODS: Patients enrolled in the EURObservational Research Programme in AF General Long-Term Registry were categorized into 3 categories: No Malignancy (NoMal), Prior Malignancy (PriorMal) and Active Malignancy (ActiveMal). The primary outcomes were all-cause death and the composite outcome MACE. RESULTS: A total of 10 383 patients were analysed. Of these, 9597 (92.4%) were NoMal patients, 577 (5.6%) PriorMal and 209 (2%) ActiveMal. Lack of any antithrombotic treatment was more prevalent in ActiveMal patients (12.4%) as compared to other groups (5.0% vs 6.3% for PriorMal and NoMal, p < .001). After a median follow-up of 730 days, there were 982 (9.5%) deaths and 950 (9.7%) MACE events. ActiveMal was independently associated with a higher risk for all-cause death (HR 2.90, 95% CI 2.23-3.76) and MACE (HR 1.54, 95% CI 1.03-2.31), as well as any haemorrhagic events and major bleeding (OR 2.42, 95% CI 1.49-3.91 and OR 4.18, 95% CI 2.49-7.01, respectively). Use of oral anticoagulants was not significantly associated with a higher risk for all-cause death or bleeding in ActiveMal patients. CONCLUSIONS: In a large contemporary cohort of AF patients, active malignancy was independently associated with all-cause death, MACE and haemorrhagic events. Use of anticoagulants was not associated with a higher risk of all-cause death in patients with active malignancies.
AB - BACKGROUND: The management of patients with atrial fibrillation (AF) and malignancy is challenging given the paucity of evidence supporting their appropriate clinical management. PURPOSE: To evaluate the outcomes of patients with active or prior malignancy in a contemporary cohort of European AF patients. METHODS: Patients enrolled in the EURObservational Research Programme in AF General Long-Term Registry were categorized into 3 categories: No Malignancy (NoMal), Prior Malignancy (PriorMal) and Active Malignancy (ActiveMal). The primary outcomes were all-cause death and the composite outcome MACE. RESULTS: A total of 10 383 patients were analysed. Of these, 9597 (92.4%) were NoMal patients, 577 (5.6%) PriorMal and 209 (2%) ActiveMal. Lack of any antithrombotic treatment was more prevalent in ActiveMal patients (12.4%) as compared to other groups (5.0% vs 6.3% for PriorMal and NoMal, p < .001). After a median follow-up of 730 days, there were 982 (9.5%) deaths and 950 (9.7%) MACE events. ActiveMal was independently associated with a higher risk for all-cause death (HR 2.90, 95% CI 2.23-3.76) and MACE (HR 1.54, 95% CI 1.03-2.31), as well as any haemorrhagic events and major bleeding (OR 2.42, 95% CI 1.49-3.91 and OR 4.18, 95% CI 2.49-7.01, respectively). Use of oral anticoagulants was not significantly associated with a higher risk for all-cause death or bleeding in ActiveMal patients. CONCLUSIONS: In a large contemporary cohort of AF patients, active malignancy was independently associated with all-cause death, MACE and haemorrhagic events. Use of anticoagulants was not associated with a higher risk of all-cause death in patients with active malignancies.
KW - Anticoagulants
KW - Atrial Fibrillation/complications
KW - Hemorrhage/chemically induced
KW - Humans
KW - Neoplasms/drug therapy
KW - Registries
KW - Risk Factors
KW - Stroke/complications
KW - NOACs
KW - registry
KW - malignancy
KW - atrial fibrillation
KW - all-cause death
KW - cancer
UR - http://www.scopus.com/inward/record.url?scp=85131903509&partnerID=8YFLogxK
U2 - 10.1111/eci.13773
DO - 10.1111/eci.13773
M3 - Journal article
C2 - 35305020
SN - 0014-2972
VL - 52
JO - European Journal of Clinical Investigation
JF - European Journal of Clinical Investigation
IS - 7
M1 - e13773
ER -