ELEVATED RESTING HEART RATE IMPROVES RISK STRATIFICATION FOR ADVERSE CARDIOVASCULAR OUTCOMES IN CANCER PATIENTS

Mohamad Hemu; Parva Bhatt; Megan Randall; Aamir Ahmed; Caleb J. Chiang; Andres Palomo; Jason B. Kramer; Ibtihaj Fughhi; Philip Bonomi; Tochukwu M. Okwuosa

doi:10.1016/S0735-1097(19)32371-X

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ELEVATED RESTING HEART RATE IMPROVES RISK STRATIFICATION FOR ADVERSE CARDIOVASCULAR OUTCOMES IN CANCER PATIENTS

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ELEVATED RESTING HEART RATE IMPROVES RISK STRATIFICATION FOR ADVERSE CARDIOVASCULAR OUTCOMES IN CANCER PATIENTS

Mohamad Hemu, Parva Bhatt, Megan Randall, Aamir Ahmed, Caleb J. Chiang, Andres Palomo, Jason B. Kramer, Ibtihaj Fughhi, Philip Bonomi and Tochukwu M. Okwuosa

ACC.19: The American College of Cardiology 68th Annual Scientific Sessions, Vol.73(9 Supplement 1), pp.1765-1765

03/12/2019

DOI: 10.1016/S0735-1097(19)32371-X

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Abstract

Background: Sinus tachycardia in cancer is a reflection of significant multi-system organ stressor/disease; with sparse literature describing its clinical significance. We assessed cardiovascular (CV) prognostic implications of elevated resting heart rate (eRHR) in cancer patients. Methods: We conducted a retrospective case-control study in 641 cancer patients (lung cancer, leukemia, lymphoma or multiple myeloma) at Rush University Medical Center, 2008-2016. Cases had HR > 100 bpm in ≥ 3 different clinic visits within 1 yr of cancer diagnosis; excluding history of pulmonary embolism, thyroid dysfunction, ejection fraction < 50%, atrial fibrillation/flutter, HR > 180 bpm. Adverse CV outcomes (ACVO) were heart failure with preserved ejection fraction (HFpEF), HF with reduced EF (HFrEF), hospital admissions for HF exacerbation (AHFE), and acute coronary syndrome (ACS). Multivariate analysis adjusted for age, race, beta blocker use, renal disease, type of malignancy, albumin, hemoglobin. Results: There were 51 patients and 591 controls (mean age =64 yrs, 60.1% women, 76.3% white). eRHR (HR ≥ 100 vs. < 100 bpm) was an independent predictor of overall ACVO (OR 3.04, 95% CI: 1.7 - 5.5; P = 0.021). Furthermore, there was increased incidence of HFrEF (OR 4.6, 95% CI: 2.5-8.5; P= 0.000) and AHFE (OR 5.5, 95% CI: 1.6-18.5; P = 0.023); but not HFpEF or ACS (p=NS) in cases vs. controls Conclusion Independent of typical factors that affect disease, eRHR is associated with ACVO in cancer patients, peri-treatment

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Title: Subtitle: ELEVATED RESTING HEART RATE IMPROVES RISK STRATIFICATION FOR ADVERSE CARDIOVASCULAR OUTCOMES IN CANCER PATIENTS
Creators: Mohamad Hemu - Rush University Medical Center
Parva Bhatt - Rush University Medical Center
Megan Randall - Rush University Medical Center
Aamir Ahmed - Rush University Medical Center
Caleb J. Chiang - Rush University Medical Center
Andres Palomo - Rush University Medical Center
Jason B. Kramer - Rush University Medical Center
Ibtihaj Fughhi - Rush University Medical Center
Philip Bonomi - Rush University Medical Center
Tochukwu M. Okwuosa - Rush University Medical Center
Resource Type: Abstract
Publication Details: ACC.19: The American College of Cardiology 68th Annual Scientific Sessions, Vol.73(9 Supplement 1), pp.1765-1765
DOI: 10.1016/S0735-1097(19)32371-X
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: ELSEVIER SCIENCE INC
Language: English
Date published: 03/12/2019
Academic Unit: Internal Medicine
Record Identifier: 9985218375902771

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