Arrhythmia-related mortality among older adults with cancer increased from an age-adjusted rate of 25 in 1999 to 47.85 in 2023 (AAPC 2.70; 95% CI 2.27-3.14; p<0.001).
Observational (n=364,298)
Yes
Arrhythmia-related mortality among older adults with cancer in the US has significantly increased from 1999 to 2023, with notable geographic and demographic disparities.
Effect estimate: AAPC 2.70 (95% CI 2.27-3.14)
Absolute Event Rate: 47.85% vs 25%
p-value: p=<0.001
e24008 Background: Arrhythmias, or irregular heart rhythms, are common in patients with cancer. They can result from the cancer itself, side effects of treatments, or other health factors. These heart rhythm problems may increase the risk of complications and affect the patient’s quality of life. Understanding how arrhythmias affect cancer patients is important, as they can influence treatment choices, outcomes, and overall health. Methods: We analyzed CDC WONDER data to estimate age-adjusted mortality rates (AAMRs) for cancer (ICD-10 C00–D48) among adults aged ≥65 years with arrhythmias (ICD-10 I44, I45, I47,I48, and I49). Temporal trends and average annual percent changes (AAPCs) were assessed using Joinpoint regression, stratified by sex, race/ethnicity, and geographic factors, including urbanization and U.S. census region. Results: A total of 364,298 deaths related to arrhythmia occurred among cancer patients, with most deaths occurring in medical facility inpatients. Overall, the age-adjusted mortality rate (AAMR) increased from 25 (95% CI: 24.47–25.53) in 1999 to 47.85 (95% CI: 47.27–48.44) in 2023 (AAPC: 2.70; 95% CI: 2.27–3.14, p < 0.001). The trend rose significantly by 2017 (APC: 1.86; p < 0.001) and continued to increase from 2017 to 2021 (APC: 6.97; p = 0.001). The increase in mortality was slightly more pronounced in women than in men (AAPC: 2.71 vs. 2.45). The highest incidence rates were observed among non-Hispanic (NH) Whites, followed by NH Blacks or African Americans, Hispanics and Latinos, and NH Asians and Pacific Islanders. Geographic disparities were evident, with the Midwest experiencing the greatest impact and the South the least. Non-metropolitan areas consistently showed higher AAMRs compared to metropolitan areas (AAPC: 3.66 vs. 2.25). From 1999–2020, Maryland, and from 2020–2023, Minnesota, ranked in the top 90th percentile. Conclusions: Arrhythmia-related deaths among cancer patients have steadily increased from 1999 to 2023, with higher rates in women and non-Hispanic Whites. The Midwest and non-metropolitan areas were most affected, showing notable geographic disparities. Focused monitoring and management are essential for the most vulnerable groups. Deaths and average annual percentage change (AAPC) per 100,000 population for arrhythmia and cancer trends, 1999-2023. Variable Deaths AAPC (95%CI) Overall 364,298 2.70 (2.27 to 3.14) Male 205,780 2.45 (1.83 to 3.08) Female 158,518 2.71 (2.39 to 3.04) NH White 70,531 3.01 (2.58 to 3.45) NH Asians 6,496 2.36 (1.25 to 3.49) Midwest 87,457 2.37 (1.89 to 2.86) South 125,475 3.48 (3.15 to 3.82) Metropolitan areas 232,422 2 25 (1.86 to 2.64) Non- Metropolitan areas 57,634 3.66 (2.90 to 4.34)
Kotak et al. (Thu,) conducted a observational in Cancer with arrhythmias (n=364,298). Temporal trends (1999-2023) was evaluated on Age-adjusted mortality rate (AAMR) (AAPC 2.70, 95% CI 2.27-3.14, p=<0.001). Arrhythmia-related mortality among older adults with cancer increased from an age-adjusted rate of 25 in 1999 to 47.85 in 2023 (AAPC 2.70; 95% CI 2.27-3.14; p<0.001).