| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Avalon, Juan Carlo Fuqua, Jacob Miller, Tyler Deskins, Seth Wakefield, Chelby King, Austin Inderbitzin-Brooks, Sonya Bianco, Christopher Veltri, Lauren Fang, Wei Craig, Michael Kanate, Abraham Ross, Kelly Malla, Midhun Patel, Brijesh |
| Abstract | Background Ibrutinib is a Bruton’s tyrosine kinase inhibitor used in the treatment of hematological malignancies. The most common cardiotoxicity associated with ibrutinib is atrial arrhythmia (atrial fibrillation and flutter). It is known that patients with cardiovascular disease (CVD) are at an increased risk for developing atrial arrhythmia. However, the rate of atrial arrhythmia in patients with pre-existing CVD treated with ibrutinib is unknown. Objective This study examined whether patients with pre-existing CVD are at a higher risk for developing atrial arrhythmias compared to those without prior CVD. Methods A single-institution retrospective chart review of patients with no prior history of atrial arrhythmia treated with ibrutinib from 2012 to 2020 was performed. Patients were grouped into two cohorts: those with CVD (known history of coronary artery disease, heart failure, pulmonary hypertension, at least moderate valvular heart disease, or device implantation) and those without CVD. The primary outcome was incidence of atrial arrhythmia, and the secondary outcomes were all-cause mortality, risk of bleeding, and discontinuation of ibrutinib. The predictors of atrial arrhythmia (namely atrial fibrillation) were assessed using logistic regression. A Cox-Proportional Hazard model was created for mortality. Results Patients were followed for a median of 1.1 years. Among 217 patients treated with ibrutinib, the rate of new-onset atrial arrhythmia was nearly threefold higher in the cohort with CVD compared to the cohort without CVD (17% vs 7%, p = 0.02). Patients with CVD also demonstrated increased adjusted all-cause mortality (OR 1.9, 95% CI 1.06-3.41, p = 0.01) and decreased survival probability (43% vs 54%, p = 0.04) compared to those without CVD over the follow-up period. There were no differences in risk of bleeding or discontinuation between the two cohorts. Conclusions Pre-existing cardiovascular disease was associated with significantly higher rates of atrial arrhythmia and mortality in patients with hematological malignancies managed with ibrutinib. |
| Related Links | https://cardiooncologyjournal.biomedcentral.com/counter/pdf/10.1186/s40959-021-00125-8.pdf |
| Ending Page | 8 |
| Page Count | 8 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 20573804 |
| DOI | 10.1186/s40959-021-00125-8 |
| Journal | Cardio-Oncology |
| Issue Number | 1 |
| Volume Number | 7 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2021-11-19 |
| Access Restriction | Open |
| Subject Keyword | Oncology Cardiology Ibrutinib Atrial fibrillation Cardio-oncology Cardiovascular disease Arrhythmia Hematologic malignancy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Cardiology and Cardiovascular Medicine |
| Journal Impact Factor | 3.2/2023 |
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