Abstract 16187: Incidence, Risk Factors, and Outcomes of Atrial Fibrillation After Blood and/or Marrow Transplant

Abstract

Introduction: Atrial fibrillation (AF) is known to occur after blood and/or marrow transplant (BMT) and has been shown to increase morbidity and mortality. Our objective was to characterize the incidence, risk factors, and clinical impact of AF in patients within the first 90 days after BMT. Methods: Patients with active malignancy undergoing BMT from 2012-2016 at the Medical College of Wisconsin were included (n=1159). Medical records were reviewed for baseline patient characteristics, AF risk factors, and clinical outcomes. Patients were categorized based on development of AF within 90 days post-BMT. Baseline characteristics and risk factors were analyzed to determine predictors for AF and all-cause mortality at 90 days. Results: Amongst the entire cohort, 5.3% of patients developed AF within the first 90 days after BMT. Significant baseline differences between those with or without AF post-BMT are outlined in Table 1. Multivariable analysis showed that a history of AF (OR: 6.7; 95% CI: 3.3-13.6; P = <0.001) and prior XRT (OR: 2.3; 95% CI: 1.2-4.6; P = 0.018) were independent predictors of developing AF. Univariate analysis demonstrated that AF was associated with 90-day mortality (HR: 7.6; 95% CI: 3.5-16.5; log rank P < 0.001). Multivariable analysis (adjusted for age, gender, race, history of XRT, BMT type, and malignancy type) revealed that female gender (HR: 2.6; 95% CI: 1.2-5.5; P = 0.016), non-Caucasian race (HR: 2.7; 95% CI: 1.1-6.4; P = 0.024) and development of AF (HR: 9.2; 95% CI: 3.7-21.5; P < 0.001) were significant independent predictors of early mortality. Conclusions: This analysis demonstrated that a prior history of AF and prior XRT were independent predictors for the development of AF in the early period post-BMT and AF is a significant independent predictor of early mortality after BMT. Further studies assessing the potential benefits of AF prevention in patients after BMT is warranted.