January 25, 2019
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Tachycardia increases incidence of mortality in patients with cancer

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Patients with cancer and tachycardia had an increased risk for mortality near the time of treatment, according to results presented at the American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient conference.

“Tachycardia is a secondary process to an underlying disease and reflective of significant multisystem organ stress and disease in cancer patients,” Mohamad Hemu, MD, resident at Rush University Medical Center in Chicago, said in a press release. “As a result, the most important initial step is to figure out what is causing the tachycardia. Reversible causes like dehydration and infections should be ruled out. Additionally, cardiopulmonary processes such as pulmonary embolism and other arrhythmias must be taken into consideration. Once these and all other causes of tachycardia are ruled out, then it is more likely that sinus tachycardia is a marker of poorer prognosis in these patients.”

Researchers analyzed data from 622 patients (mean age, 70 years; 61% women) with cancer from 2008 to 2016, of whom 50 patients had tachycardia and 572 were in the control group.

Patients had tachycardia in more than three different clinical visits within 1 year of their cancer diagnosis. The types of cancer patients had included leukemia, lung cancer, multiple myeloma or lymphoma.

Of the patients in the study, 69.4% had stage 4 cancer according to the American Joint Committee on Cancer and 43% had lung cancer.

Researchers assessed two different models for the effect of tachycardia on mortality. Model 1 was adjusted for age and covariates, whereas model 2 was adjusted for age and other clinically relevant characteristics. Both models found that tachycardia was a significant predictor of mortality (model 1: HR = 3.1; 95% CI, 1.8-5.1; model 2: HR = 2.8; 95% CI, 1.7-4.6).

“We need to do more studies to determine whether management of tachycardia in cancer patients will have any effect on survival,” Tochi M. Okwuosa, DO, director of the cardio-oncology program at Rush University Medical Center, said in the release. – by Darlene Dobkowski

Reference:

Hemu M, et al. Control #11. Presented at: Advancing the Cardiovascular Care of the Oncology Patient; Jan. 25-27, 2019; Washington, D.C.

Disclosure: Cardiology Today could not confirm relevant financial disclosures at the time of publication.