Document Type
Article
Publication Date
3-9-2023
Abstract
Background
There are limited data on risk of arrhythmias among patients with lymphoproliferative disorders. We designed this study to determine the risk of atrial and ventricular arrhythmia during treatment of lymphoma in a real‐world setting.Methods and Results
The study population comprised 2064 patients included in the University of Rochester Medical Center Lymphoma Database from January 2013 to August 2019. Cardiac arrhythmias—atrial fibrillation/flutter, supraventricular tachycardia, ventricular arrhythmia, and bradyarrhythmia—were identified using International Classification of Diseases, Tenth Revision (ICD‐10) codes. Multivariate Cox regression analysis was used to assess the risk of arrhythmic events with treatments categorized as Bruton tyrosine kinase inhibitor (BTKi), mainly ibrutinib/non‐BTKi treatment versus no treatment. Median age was 64 (54–72) years, and 42% were women. The overall rate of any arrhythmia at 5 years following the initiation of BTKi was (61%) compared with (18%) without treatment. Atrial fibrillation/flutter was the most common type of arrhythmia accounting for 41%. Multivariate analysis showed that BTKi treatment was associated with a 4.3‐fold (P<0.001) increased risk for arrhythmic event (P<0.001) compared with no treatment, whereas non‐BTKi treatment was associated with a 2‐fold (P<0.001) risk increase. Among subgroups, patients without a history of prior arrhythmia exhibited a pronounced increase in the risk for the development of arrhythmogenic cardiotoxicity (3.2‐fold; P<0.001).Conclusions
Our study identifies a high burden of arrhythmic events after initiation of treatment, which is most pronounced among patients treated with the BTKi ibrutinib. Patients undergoing treatments for lymphoma may benefit from prospective focused cardiovascular monitoring prior, during, and after treatment regardless of arrhythmia history.Recommended Citation
Sherazi, Saadia; Schleede, Susan; McNitt, Scott; Casulo, Carla; Moore, Jeremiah E.; Storozynsky, Eugene; Patel, Arpan; Vidula, Neelima; Aktas, Mehmet K.; Zent, Clive S.; and Goldenberg, Ilan, "Arrhythmogenic Cardiotoxicity Associated With Contemporary Treatments of Lymphoproliferative Disorders" (2023). Division of Cardiology Faculty Papers. Paper 120.
https://jdc.jefferson.edu/cardiologyfp/120
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
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Supplementary Materials
Supplementary Materials
Language
English
PubMed ID
36892046
Comments
This article is the author's final published version in the Journal of the American Heart Association, Volume 12, Issue 6, 21 March 2023.
The published version is available at https://doi.org/10.1161/JAHA.122.025786. Copyright © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.