The Impact of Atrial Fibrillation on Morbidity and Mortality Among Patients With CLL
Findings from a recent study suggest that patients with chronic lymphocytic leukemia (CLL) with atrial fibrillation (AF) may be at a significantly increased risk of all-cause mortality, cardiac-related mortality, and stroke (Clin Lymphoma Myeloma Leuk. 2022; 22[2]:98-104. doi:10.1016/j.clml.2021.08.006).
The risk of AF in patients with CLL has been rising, but the burden added by AF to the morbidity and mortality is unknown.
Mohammad Ammad Ud Din, MD, Department of Internal Medicine, Rochester General Hospital, Rochester, NY, and colleagues aimed to determine the excess burden added by AF to the morbidity and mortality of CLL patients especially in the hospitalized setting.
Data from the years 2009 through 2018 on patients with CLL with AF were extracted from The National Inpatient Sample database, and propensity-score matching (PSM) and logistic regression models were conducted.
A total of 7265 CLL admissions with AF and 7265 CLL admissions without AF were identified.
“The primary outcome was all-cause mortality (ACM), while the secondary outcomes included acute coronary syndrome (ACS), acute myocardial infarction (AMI), and the need for percutaneous coronary intervention (PCI), acute heart failure (AHF), acute hypoxic respiratory failure (AHRF), cardiac arrest (CA), cardiogenic shock (CS), stroke, and the total cost of hospitalization,” wrote Dr Ud Din and colleagues.
The rate of ACM among patients with CLL with AF was 6.06%, and 4.47% among patients with CLL without AF (P <.001). In patients with CLL with AF, secondary outcomes including ACS, AMI, PCI, AHRF, CA, CS, and stroke were observed at a significantly higher rate than those without AF.
The median total hospital cost in patients with CLL with and without AF was $9097 and $7646, respectively (P <.0001).
“CLL patients with AF are at a significantly increased risk of all-cause mortality, cardiac-related mortality, and stroke,” concluded Dr Ud Din and colleagues, adding, “For this population, a multidisciplinary approach should be orchestrated for better management and outcomes.”
