Abstract 20758: Chemotherapy Treatment Increases the Risk of Developing Atrial Fibrillation in Breast Cancer
Introduction: With an aging population and increasing cancer survivors, radiotherapy and chemotherapy mediated cardiovascular disease is becoming more prevalent. However, little is currently known about the impact that these different treatment modalities have on the prevalence of atrial fibrillation (AF).
Hypothesis: Chemotherapy increases incident AF in patients with breast cancer.
Methods: We conducted a retrospective review from 1994 to 2014 in the electronic medical record (EMR) on patients treated with radiotherapy and/or chemotherapy for breast cancer. Incident AF was detected using a validated algorithm. Radiotherapy data was obtained from radiation oncology treatment reports. Chemotherapy data was extracted from patient charts and forty-three different chemotherapy drugs were examined from 8 classes consisting of: Tyrosine Kinase Inhibitors, Alkylating Agents, Monoclonal Antibodies, Antimetabolites, Mitotic Inhibitors, Hormonal Modifiers, Topoisomerase Inhibitors and Antineoplastic Antibiotics. These were further categorized into the 16 most commonly used treatment regimens for breast cancer.
Results: 2,124 breast cancer patients with a 4% prevalence of AF and mean (SD) age 58.9 (12.8) years were part of the analysis. For individual chemotherapy agents, we observed Ifosfamide (Alkylating Agent) increasing the risk of AF (P = 0.023). In regimen-based chemotherapies, we found combination of Docetaxel (Mitotic Inhibitor) and Capecitabine (Antimetabolite) to synergistically increase the likelihood of AF (P = 0.026). The same regimen but without radiotherapy was not associated with AF (P = >0.05). When adjusting for age, sex, race, body mass index, coronary artery disease, hypertension, diabetes mellitus, and heart failure, only Ifosfamide remained significantly associated with incident AF in patients with or without radiotherapy at any point respectively (OR = 4.108, CI - 0.003 to 0.906, P = 0.043 and OR = 3.982, CI - 0.003 to 0.949, P = 0.046).
Conclusions: We identified one chemotherapy agent and regimen in breast cancer patients to significantly impact the development of AF. While these findings need to be confirmed, caution should be given when prescribing these chemotherapies for breast cancer in at-risk AF populations.
Author Disclosures: B. Chalazan: None. R. Lentz: None. M. McCauley: None. M. Kolek: None. E. Farber-Eger: None. Q. Wells: None. J. Moslehi: None. D. Darbar: None.
- © 2016 by American Heart Association, Inc.