دورية أكاديمية
Atrial fibrillation burden and clinical outcomes following BTK inhibitor initiation.
| العنوان: | Atrial fibrillation burden and clinical outcomes following BTK inhibitor initiation. |
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| المؤلفون: | Gambril JA; Department of Internal Medicine, Ohio State University Medical Center, Columbus, OH, USA. alangambril@gmail.com.; Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA. alangambril@gmail.com., Ghazi SM; Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA., Sansoterra S; Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA., Ferdousi M; Department of Internal Medicine, Ohio State University Medical Center, Columbus, OH, USA., Kola-Kehinde O; Department of Internal Medicine, Ohio State University Medical Center, Columbus, OH, USA., Ruz P; Department of Internal Medicine, Ohio State University Medical Center, Columbus, OH, USA., Kittai AS; Division of Hematology, The Ohio State University, Columbus, OH, USA., Rogers K; Division of Hematology, The Ohio State University, Columbus, OH, USA., Grever M; Division of Hematology, The Ohio State University, Columbus, OH, USA., Bhat S; Division of Hematology, The Ohio State University, Columbus, OH, USA., Wiczer T; Department of Pharmacy, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA., Byrd JC; Department of Medicine, University of Cincinnati, Cincinnati, OH, USA., Woyach J; Division of Hematology, The Ohio State University, Columbus, OH, USA., Addison D; Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA. Daniel.Addison@osumc.edu.; Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA. Daniel.Addison@osumc.edu. |
| المصدر: | Leukemia [Leukemia] 2024 Aug 17. Date of Electronic Publication: 2024 Aug 17. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Nature Publishing Group, Specialist Journals Country of Publication: England NLM ID: 8704895 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5551 (Electronic) Linking ISSN: 08876924 NLM ISO Abbreviation: Leukemia Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2000- : London : Nature Publishing Group, Specialist Journals Original Publication: [Baltimore, Md.] : Williams & Wilkins, [c1987- |
| مستخلص: | Bruton's tyrosine kinase inhibitors (BTKi) have dramatic efficacy against B-cell malignancies, but link with cardiotoxicity, including atrial fibrillation (AF). Burden, severity, and implications of BTKi-related AF are unknown. Leveraging a large-cohort of consecutive B-cell malignancy patients initiated on BTKi from 2009-2020, we identified patients with extended ambulatory rhythm monitoring. The primary outcome was AF burden after BTKi-initiation. Secondary outcomes included ventricular arrhythmia burden and other arrhythmias. Observed incident-AF rates and burden with next-generation BTKi's were compared to ibrutinib. Multivariable regression defined association between rhythm measures and major adverse cardiac events (MACE), and mortality. There were 98 BTKi-treated patients [38.8% next-generation BTKi's, 14.3% prior-AF], with 28,224 h of monitoring. Median duration BTKi-use was 34 months. Over mean duration 12 days monitoring, 72.4% developed arrhythmias (16.3% incident-AF, 31.6% other SVTs, 14.3% ventricular tachycardia). 14.3% had high AF-burden. AF-burden was similar between ibrutinib and next-generation BTKi's. No single antiarrhythmic-therapy prevented BTKi-related AF. However, antiarrhythmic initiation associated with reduction in arrhythmic burden (P = 0.009). In a multivariable model accounting for traditional cardiovascular risk factors, prior-AF associated with increased post-BTKi AF-burden. In follow-up, high AF burden associated with MACE (HR 3.12, P = 0.005) and mortality (HR 2.97, P = 0.007). Among BTKi-treated patients, high AF burden prognosticates future MACE and mortality risk. (© 2024. The Author(s).) |
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| معلومات مُعتمدة: | CDP 2331-20 Leukemia and Lymphoma Society (Leukemia & Lymphoma Society); CDP 2331-20 Leukemia and Lymphoma Society (Leukemia & Lymphoma Society); R01-CA197870 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); R35-CA197734 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); K12-CA133250 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); R01HL170038 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); K23-CA178183 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); R01-CA197870 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); R01HL170038 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); K23-HL155890 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); R01HL170038 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics); R01HL1168045 U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (National Cancer Institute Division of Cancer Epidemiology and Genetics) |
| تواريخ الأحداث: | Date Created: 20240817 Latest Revision: 20240817 |
| رمز التحديث: | 20240818 |
| DOI: | 10.1038/s41375-024-02334-3 |
| PMID: | 39154059 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1476-5551 |
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| DOI: | 10.1038/s41375-024-02334-3 |