临床与实验心脏病学
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In-Hospital Outcomes of Patients with Atrial Fibrillation and a Concurrent History of Radiotherapy

Akanimo Antia1*, Ovie Okorare2, Daniel Ubokudom3, Emmanuel Daniel4, Olanrewaju Adabale5, Favour Markson1

Background: Atrial Fibrillation (AF) is the most common arrhythmia, with a prevalence of about 2.7 million to 6.1 million and is associated with a two-fold increase in mortality and major adverse cardiovascular events. Studies have shown relationships between AF, cancers and cancer therapies (radiotherapy, chemotherapy).

Objective: This study is focused on the in-hospital outcomes of patients with AF and a history of Radiotherapy (RT) for solid chest cancers.

Methods: This was a retrospective study done using the National In-patient Database (NIS). We identified patients who were admitted with atrial fibrillation and had a history of radiotherapy for a solid chest cancer (including breast and lung cancers), evaluated their associated socio-demographic and comorbid factors using ICD-10 codes. We utilized the chi-square test to compare baseline characteristics and multivariate logistic regression to identify outcomes.

Results: 2,294,144 with primary diagnoses of AF were identified, of which 5,465 also had concurrent history of radiotherapy for solid chest malignancies. We noted that the study population had significant smoking history and Charlson comorbidity index of ≥ 3. We observed significant mortality rates ((adjusted Odds Ratio) aOR 2.5, CI 1.7-3.57, p<0.001) and respiratory failure. We also noted CHF, dyslipidemia and history of RT as independent predictors of AF in patients with solid chest cancers. There were no significant differences in the mean length of stay but our studied population incurred lower hospital charges ($44,380 vs. $46,257).

Conclusion: A history of radiotherapy for solid chest malignancies is associated with worse outcomes in patients with AF. A history of radiotherapy for solid chest malignancies is associated with worse outcomes in patients with AF.