Elbadawi A, et al. - In this study, researchers used the Nationwide Inpatient Survey Database to determine the impact of cancer on cerebrovascular accidents in patients with atrial fibrillation (AF). Based on the findings, they concluded that in-hospital CVA among AF patients may not be better predicted by cancer diagnosis beyond the CHADS2VASc score.

Methods

• Among patients with AF who had lung, breast, colon and esophageal cancer vs those who did not (control), a 1:1 propensity matching was performed based on the CHA2DS2VASc score and other risk factors.

Results

• A total of 31,604 patients were included in the final cohort.
• In the cancer group vs the control group, the primary outcome of in-hospital CVA was lower (4% vs. 7%, p<0.001), but with only a weak association (ф=-0.067).
• Furthermore, it was noted that in the cancer group vs the control group, in-hospital mortality was higher (18% vs 11%, p<0.001; ф=-0.099).
• Researchers found that a subgroup analysis according to cancer type demonstrated similar results with a weak association with lower CVA in breast cancer (4% vs 7%; ф=-0.066, p<0.001), lung cancer (4% vs 6%; ф=-0.062, p<0.001), colon cancer (4% vs 6%; ф= -0.062, p<0.001) and esophageal cancer (3% vs 7%; ф=-0.095, p<0.001) compared with the control groups.
• They also noted a weak association with higher in-hospital mortality in lung cancer (20% vs 11%; ф=-0.127, p<0.001), colon cancer (16% vs 11%; ф=-0.076, p<0.001) and esophageal cancer (20% vs 12%; ф=-0.111, p<0.001) vs the control groups, but no significant difference between breast cancer and control groups in mortality (11% vs 11%; ф=-0.002, p=0.888).