Abstract 11849: The Influence of Atrial Fibrillation on Mortality Among Cancer Patients

Abstract

Background: Although atrial fibrillation (AF) is associated with an increased risk of mortality in the general population, it is less studied in cancer patients. Methods: Using an observational registry in Japan, adult patients diagnosed with cancer at the Kumamoto University Hospital between 2007 and 2018 were identified. The trend in the prevalence of AF and their effects on all-cause mortality were investigated. Results: As many as 30,706 cancer patients were identified, and 19,496 patients were included after excluding patients with significant missing values. The overall median follow-up time was 4.5 years. The prevalence of AF was steady during the study period (n=250, 1.3%), and anticoagulation drugs were used in approximately 90% of patients with CHADS 2 scores ≥ 1. The Kaplan-Meier analysis revealed that AF patients had a lower survival estimate compared with non-AF patients (adjusted HR, 1.23; 95% CI, 1.01-1.49) (Figure 1). Subgroup analyses indicated that AF patients treated with warfarin or without any anticoagulation drugs were associated with poor prognosis (adjusted HR, 1.30; 95% CI, 1.05-1.61, adjusted HR, 1.91; 95% CI, 1.06-3.46, respectively), however, AF patients treated with direct oral anticoagulants were not associated with it (adjusted HR, 0.65; 95% CI, 0.36-1.17) compared with non-AF patients. Conclusions: Approximately 1.3% of cancer patients had AF, and the majority received anticoagulation treatments. AF seemed to be associated with poor prognosis among cancer patients, and the extent of association varied across anticoagulation strategies. Further studies are warranted to investigate the influence of AF and its anticoagulation strategies on cancer patients.