P1914 - Atrial Fibrillation-Related Mortality Patterns in Patients With Gastrointestinal Cancer in the United States: A Retrospective Analysis from 1999 to 2020
Services Institute of Medical Sciences Lahore, Punjab, Pakistan
Eeshal Fatima, MBBS1, Khawaja Abdul Rehman, MBBS2,Zoha Shahzad, MBBS3, Syed Adeel Hassan, MBBS4, Umar Akram, 5, Osama Ijaz, MBBS1 1Services Institute of Medical Sciences, Lahore, Punjab, Pakistan; 2CMH Lahore Medical College, Lahore, Punjab, Pakistan; 3Fatima Jinnah Medical University, Lahore, Punjab, Pakistan; 4University of Kentucky, Lexington, KY; 5Allama Iqbal Medical College, Lahore, Punjab, Pakistan
Introduction: Gastrointestinal (GI) cancers represent a significantly increasing national healthcare burden. Despite advancements in cancer-related therapies, concerns persist regarding treatment-induced cardiac complications, notably atrial fibrillation (AF). However, the association between AF and GI malignancy remains poorly elucidated with studies suggesting a bidirectional relationship in terms of incidence and all-cause mortality. Therefore, our study aims to investigate the mortality trends attributable to AF among patients with GI cancers in the US stratified by year, sex, race, and region.
Methods: We retrieved mortality data from the CDC WONDER database and determined the crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals. We examined the changes in AAMR through annual percent change (APC) and the average annual percent change (AAPC) using Joinpoint regression.
Results: A total of 44,764 deaths occurred in the patients of GI cancers with AF in the US from 1999-2020, demonstrating an overall rising trend (AAPC = 3.79). Colorectal cancer accounted for the highest number of AF-related deaths (20,417), followed by pancreatic cancer (8721), and esophageal cancer (6205). Males (1.44) had a significantly higher AAMR than females (0.64). Non-Hispanic (NH) Whites had the highest AAMR (1.09), while Hispanics (0.56) and NH Asian or Pacific Islanders had the lowest (0.58). Although there were no significant variations in the AAMRs of different regions (West: 1.1, Midwest: 1.08, Northeast: 1.04, South: 0.89), a sharp rise was observed in the South region from 2016 to 2020 (APC = 11.08), and Midwest region from 2015 to 2020 (APC = 7.25). The states with the highest AAMR were Rhode Island (1.72) and Nebraska (1.54), while the states with the lowest AAMR were Nevada (0.49) and New Mexico (0.55). Non-metropolitan areas had a higher AAMR than metropolitan areas. The highest number of deaths were reported in a medical facility (18,100), followed by the decedent’s home (14,528).
Discussion: Adults in the US have shown a rising trend in AF-related death in patients with GI malignancies, with the highest mortality rates seen in men and NH Whites. Our study emphasizes the need for providing targeted cardiovascular care in specific at-risk populations. This warrants a more proactive approach involving optimal care coordination between oncologists and cardiologists. Future research should analyze underlying mechanisms and optimal management strategies.
Figure: (A) Trends in overall age-adjusted mortality rates; (B) Sex-stratified age-adjusted mortality rates; (C) Racial stratification in the trends of age-adjusted mortality rates; (D) Trends in age-adjusted mortality rates stratified by rural-urban status * indicates annual percent change is significantly different from zero at alpha = 0.05 level
Disclosures:
Eeshal Fatima indicated no relevant financial relationships.
Khawaja Abdul Rehman indicated no relevant financial relationships.
Zoha Shahzad indicated no relevant financial relationships.
Syed Adeel Hassan indicated no relevant financial relationships.
Umar Akram indicated no relevant financial relationships.
Osama Ijaz indicated no relevant financial relationships.
Eeshal Fatima, MBBS1, Khawaja Abdul Rehman, MBBS2, Zoha Shahzad, MBBS3, Syed Adeel Hassan, MBBS4, Umar Akram, 5, Osama Ijaz, MBBS1. P1914 - Atrial Fibrillation-Related Mortality Patterns in Patients With Gastrointestinal Cancer in the United States: A Retrospective Analysis from 1999 to 2020, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
