Associations between sinus tachycardia and adverse cardiovascular outcomes and mortality in cancer patients

Mohamad Hemu; Caleb J. Chiang; Parva K. Bhatt; Aamir Ahmed; Kyaw Zaw Hein; Talal Mourad; Megan E. Randall; Andres P. Palomo; Jason B. Kramer; Ibtihaj Fughhi; Louis Fogg; Philip Bonomi; Tochukwu M. Okwuosa

doi:10.21037/jtd-21-779

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Associations between sinus tachycardia and adverse cardiovascular outcomes and mortality in cancer patients

Journal article

Open access

Peer reviewed

Associations between sinus tachycardia and adverse cardiovascular outcomes and mortality in cancer patients

Mohamad Hemu, Caleb J. Chiang, Parva K. Bhatt, Aamir Ahmed, Kyaw Zaw Hein, Talal Mourad, Megan E. Randall, Andres P. Palomo, Jason B. Kramer, Ibtihaj Fughhi, …

Journal of thoracic disease, Vol.13(8), pp.4845-4852

08/01/2021

DOI: 10.21037/jtd-21-779

PMID: 34527323

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Abstract

Background: Sinus tachycardia in cancer reflects a significant multi-system organ stressor and disease, with sparse literature describing its clinical significance. We assessed cardiovascular (CV) and mortality prognostic implications of sinus tachycardia in cancer patients. Methods: We conducted a case-control study of 622 cancer patients at a U.S. urban medical center from 2008 to 2016. Cases had ECG-confirmed sinus tachycardia [heart rate (HR) >_100 bpm] in >_3 different clinic visits within 1 year of cancer diagnosis excluding a history of pulmonary embolism, thyroid dysfunction, left ventricular 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), acute coronary syndrome (ACS). Regression analyses were conducted to examine the effect of sinus tachycardia on overall ACVO and survival. Results: There were 51 cases, age and sex-matched with 571 controls (mean age 70 +/- 10, 60.5% women, 76.4% Caucasian). In multivariate analysis over a 10-year follow-up period, sinus tachycardia (HR >_100 vs. <100 bpm) was an independent predictor of overall ACVO (OR 2.8, 95% CI: 1.4-5.5; P=0.006). There was increased incidence of HFrEF (OR 3.3, 95% CI: 1.6-6.5; P=0.004) and AHFE (OR 6.3, 95% CI: 1.6-28; P=0.023), but not HFpEF or ACS (P>0.05) compared with controls. Sinus tachycardia was a significant predictor of overall mortality after adjusting for significant covariates (HR 2.9, 95% CI 1.8-5; P<0.001). Conclusions: Independent of typical factors that affect cardiovascular disease, sinus tachycardia around the time of cancer treatment is associated with increased ACVO and mortality in cancer patients at 10 years of follow-up.

Life Sciences & Biomedicine

Respiratory System

Science & Technology

Details

Title: Subtitle: Associations between sinus tachycardia and adverse cardiovascular outcomes and mortality in cancer patients
Creators: Mohamad Hemu - Rush University Medical Center
Caleb J. Chiang - Rush University Medical Center
Parva K. Bhatt - Rush University Medical Center
Aamir Ahmed - Rush University Medical Center
Kyaw Zaw Hein - Rush University Medical Center
Talal Mourad - University of Illinois Urbana-Champaign
Megan E. Randall - Rush University Medical Center
Andres P. Palomo - Rush University Medical Center
Jason B. Kramer - Rush University Medical Center
Ibtihaj Fughhi - Rush University Medical Center
Louis Fogg - Rush University Medical Center
Philip Bonomi - Rush University Medical Center
Tochukwu M. Okwuosa - Rush University Medical Center
Resource Type: Journal article
Publication Details: Journal of thoracic disease, Vol.13(8), pp.4845-4852
DOI: 10.21037/jtd-21-779
PMID: 34527323
NLM abbreviation: J Thorac Dis
ISSN: 2072-1439
eISSN: 2077-6624
Publisher: AME PUBLISHING COMPANY
Number of pages: 8
Language: English
Date published: 08/01/2021
Academic Unit: Internal Medicine
Record Identifier: 9985218376202771

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