Open AccessIncidence of Cancer Treatment–Induced Arrhythmia Associated With Novel Targeted Chemotherapeutic Agents
Author(s) -
Nickel Andrew C.,
Patel Akshar,
Saba Nabil F.,
Leon Angel R.,
ElChami Mikhael F.,
Merchant Faisal M.
Publication year - 2018
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.010101
Subject(s) - medicine , hazard ratio , confidence interval , heart failure , anthracycline , incidence (geometry) , chemotherapy , cancer , surgery , cardiology , breast cancer , physics , optics
Background The incidence of cancer treatment–induced arrhythmia ( CTIA ) associated with novel, targeted chemotherapeutic agents ( TCA s) has not been well described. Methods and Results We identified all patients treated at our institution from January 2010 to December 2015 with selected TCA s. We defined CTIA as any new arrhythmia diagnosis code within 6 months after treatment initiation. As a comparison, we also identified patients treated with anthracycline chemotherapy during the same period. We identified 5026 patients, of whom 2951 (58.7%) received TCA s and 2075 (41.3%) received anthracycline chemotherapy. In the overall cohort, 601 patients (12.0%) developed CTIA . Patients with CTIA were significantly older and more likely to have hypertension, diabetes mellitus, congestive heart failure, coronary disease, and sleep apnea. The incidence of CTIA at 6 months was significantly lower in the TCA group (9.3% versus 15.8%; P <0.001). In multivariate analysis, a history of hypertension (hazard ratio, 1.63; 95% confidence interval, 1.34–1.98), congestive heart failure (hazard ratio, 2.12; 95% confidence interval, 1.78–2.68), and male sex (hazard ratio, 1.25; 95% confidence interval, 1.06–1.47) were associated with a significantly increased risk of CTIA , whereas treatment with TCA s, compared with anthracycline chemotherapy, was associated with a significantly lower risk (hazard ratio, 0.60; 95% confidence interval, 0.51–0.71). Conclusions Compared with anthracyclines, treatment with TCAs was associated with an ≈40% reduced risk of new‐onset arrhythmia diagnoses during the first 6 months of treatment.