Abstract
Background: Arrhythmias are common cardiovascular complications in multiple myeloma (MM) patients and are related to a poor prognosis.Objective: This study aimed to assess the burden of arrhythmias and their prognostic value in patients with MM.Methods: This was a retrospective study of patients with MM between January 2015 and April 2020 at the First Affiliated Hospital of Xi'an Jiaotong University. The incidence of arrhythmia and associated risk factors were evaluated. The relationship between the type of arrhythmia and survival was analyzed.Results: A total of 319 patients with MM were identified, and 48.0% (153/319) had arrhythmias. The most common type of arrhythmia was sinus tachycardia (ST) (15.0%, 48/319), followed by sinus bradycardia (SB) (14.4%, 46/319), premature atrial contractions (PACs) (6.3%, 20/319), conduction disorders (CDs) (6.0%, 19/319), atrial fibrillation (AF) (6.0%, 19/319), premature ventricular contractions (PVCs) (4.4%, 14/319) and paroxysmal supraventricular tachycardia (PSVT) (0.6%, 2/319). The patients with arrhythmias had higher levels of log NT-proBNP and creatinine, greater bortezomib use, and a higher incidence of diabetes than those without arrhythmias (P < 0.05). The all-cause mortality rates of patients without arrhythmias and those with AF, ST, PACs, CDs, SB, and PVCs were 50.6% (84/166), 73.7% (14/19), 60.4% (29/48), 60.0% (12/20), 52.6% (10/19), 34.8% (16/46), and 28.6% (4/14), respectively. In a subgroup analysis of patients experiencing different types of arrhythmias, patients with SB had lower all-cause mortality than patients with AF (P < 0.01). Univariate and multivariate Cox analyses showed that there was a positive statistically significant association between SB and survival (HR: 0.592 [0.352–0.998], P = 0.049) in a subgroup analysis of different arrhythmias.Conclusions: Patients with MM had a heavy arrhythmia burden, and in this study, approximately half of MM patients had arrhythmias. MM patients with SB were associated with lower all-cause mortality than those with AF. SB might be an independent positive factor for prognosis.
Highlights
Multiple myeloma (MM) is one of the most common malignant hematologic tumors, accounting for 10% of hematopoietic tissue tumors and 1% of all cancers [1]
Chemotherapy agents including bortezomib, lenalidomide, thalidomide, anthracyclines, cyclophosphamide and supportive care measures were compared between the two groups
The percentage of patients with diabetes was higher in the group with arrhythmias than in the group without arrhythmias (16.3 vs. 8.4%, P = 0.031)
Summary
Multiple myeloma (MM) is one of the most common malignant hematologic tumors, accounting for 10% of hematopoietic tissue tumors and 1% of all cancers [1]. With advancements in biologically targeted treatment in recent years, the survival of MM patients has improved significantly [3]. Cardiac complications such as arrhythmias are common in patients with MM [4, 5]. One study including ∼20% of all United States community hospitals used a nationwide inpatient sample dataset and reported the burden of cardiac arrhythmias in patients with MM [6]. The burden of different arrhythmias and the relation between these arrhythmias and prognostic survival in MM patients remain unclear in real-world studies. Arrhythmias are common cardiovascular complications in multiple myeloma (MM) patients and are related to a poor prognosis
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