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 - The ESC-EHRA EORP-AF Long-Term General Registry Investigators
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 - Goda, A.
AU - Mairesse, G.
AU - Shalganov, T.
AU - Antoniades, L.
AU - Taborsky, M.
AU - Riahi, S.
AU - Muda, P.
AU - García Bolao, I.
AU - Piot, O.
AU - Etsadashvili, K.
AU - Simantirakis, E. N.
AU - Haim, M.
AU - Azhari, A.
AU - Najafian, J.
AU - Santini, M.
AU - Mirrakhimov, E.
AU - Kulzida, K.
AU - Erglis, A.
AU - Poposka, L.
AU - Burg, M. R.
AU - Crijns, H. J.G.M.
AU - Erküner,
AU - Atar, D.
AU - Lenarczyk, R.
AU - Martins Oliveira, M.
AU - Shah, D.
AU - Serdechnaya, E.
AU - Diker, E.
AU - Zëra, E.
AU - Ekmekçiu, U.
AU - Paparisto, V.
AU - Tase, M.
AU - Gjergo, H.
AU - Dragoti, J.
AU - Goda, A.
N1 - Publisher Copyright:
© 2022 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
PY - 2022/7/1
Y1 - 2022/7/1
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 - all-cause death
KW - atrial fibrillation
KW - cancer
KW - malignancy
KW - NOACs
KW - registry
UR - http://www.scopus.com/inward/record.url?scp=85131903509&partnerID=8YFLogxK
U2 - 10.1111/eci.13773
DO - 10.1111/eci.13773
M3 - Article
C2 - 35305020
AN - SCOPUS:85131903509
SN - 0014-2972
VL - 52
JO - European Journal of Clinical Investigation
JF - European Journal of Clinical Investigation
IS - 7
M1 - e13773
ER -