Atrial fibrillation is associated with worse outcomes in patients with breast cancer.

Abstract

e13043 Background: The incidence of atrial fibrillation (AF) is higher in women with breast cancer (BC) compared to aged-matched controls. A better understanding of the clinical outcomes in women with BC and AF can help stratify patients’ risk and inform clinical decision making. Methods: Females with active BC diagnosis hospitalized from January 2010 to December 2018 for any cause were identified in the Nationwide Readmissions Database (NRD). Hospitalizations were divided to females with AF and those without a known diagnosis of AF. The primary outcome was in-hospital mortality. Multivariate logistic regression analysis was performed to adjust for differences in baseline characteristics. All statistical analyses were conducted using the weighted values of observations as provided by the NRD to measure national estimates. Results: A total of 1,596,853 hospitalizations of BC were identified. Out of those, 119,307 (7.5%) had AF. Females with AF were older, median age 77 [IQR 69-84] versus 61 [51-71]. AF patients had higher rates of chronic pulmonary disease, 23.0% versus 14.3%, p < 0.001; hypothyroidism, 20.9% versus 13.1%, p < 0.001; peripheral vascular disease, 6.8% versus 2.5%, p < 0.001; pulmonary hypertension, 4.8% versus 1.6%, p < 0.001; cardiac valvular disease, 9.5% versus 2.3%, p < 0.001; hyperlipidemia, 39.9% versus 24.0%, p < 0.001; diabetes mellitus, 28.9% versus 19.8%, p < 0.001; heart failure, 37.0% versus 7.5%, p < 0.001; prior bypass surgery, 4.1% versus 1.2%, p < 0.001; prior stroke, 7.8% versus 2.5%, p < 0.001; and prior myocardial infarction, 6.0% versus 2.2%, p < 0.001. In-hospital mortality was significantly higher in patients with AF, 7.1% versus 4.1%, p < 0.001. Adjusted Odds Ratio (aOR) for in-hospital mortality was higher in AF, aOR 1.42, 95% CI (1.38-1.46), p < 0.001. Conclusions: Atrial fibrillation is associated with a higher risk of in-hospital mortality in patients with breast cancer regardless of the reason of hospitalization. Stratifying patients based on AF presence can help inform clinicians and patients of the patients’ risk of mortality during hospitalization.