PO-05-188 TRENDS OF CARDIOVASCULAR MORTALITY IN PATIENTS WITH ATRIAL FIBRILLATION AND CANCER IN THE UNITED STATES FROM 1999-2000

Abstract

Prevalence of atrial fibrillation (AF) in cancer is increasing secondary to higher life expectancy in paadvances in treatment of cancer. However, there is a bereft of information on the rates of cardiovascular mortality in patients with AF and cancer. To identify the trends of cardiovascular mortality in patients with AF and cancer. We used the CDC WONDER database to obtain the demographic and cardiovascular mortality data based on death certificates for the US population older than 35 years from 1999 to 2020. Cardiovascular disease (ICD-10-CM: I00-I99) was listed as the underlying cause of death while AF (ICD-10-CM: I48) and cancer (ICD-10-CM: C00-D48) were listed as multiple causes of death using boolean “AND” to ensure both conditions were present at the time of death. Trends of cardiovascular mortality in cases with AF and cancer were analyzed using Joinpoint regression models to calculate annual percentage changes (APC) and average annual percentage change (AAPC) along with its 95% CI and identify the best-fitting joinpoints. Subgroup analysis were performed by race, sex and age groups. As seen in figure 1a, the age adjusted mortality rates for all patients above age 35 increased significantly, with the highest increase in APC seen from 2017 to 2020 (7.3; 95% CI: 5.1-9.5; p<0.001). Patients above age 65 had the highest cardiovascular mortality, with the highest APC seen between 2017-2020 (6.97; 95% CI: 5.1-8.9; p<0.001). Subgroup analysis in patients aged more than 65 revealed that rates were higher in males (white > black) than females (white > black). Overall, from 1999-2000, the AAPC was the highest in white males (1.9; 95% CI: 1.5-2.3; p<0.001) followed by black males (1.6; 95% CI: 0.8-2.5; p<0.001) and white females (1.4; 95% CI: 1.0-1.8; p <0.001). AAPC was not significant for black females (1.8; 95% CI: -0.2-3.8; p =0.071). In a first of its kind analysis, we show that cardiovascular mortality in patients with AF and cancer is increasing across the country. While rates of cancer deaths have dropped significantly in the last two decades, the rates of cardiovascular mortality have increased in these patients. Larger studies are needed to further delineate specifics of these rising trends, which can, in turn, help in development of targeted preventive measures for these vulnerable groups.