Key result
T2DM linked to ~850% greater risk of new-onset atrial arrhythmias during antitumor therapy.
Why the study?
Patients with malignancies and type 2 diabetes mellitus face heightened cardiotoxicity risks from antitumor therapies, but the interplay between diabetes, antitumor drugs, and atrial arrhythmias remains underexplored.
What are the incidence and risk factors for new-onset atrial arrhythmias in patients with malignancies receiving antitumor therapy, and how does type 2 diabetes affect this risk?
Cohort (n=171)
No
What are the incidence and risk factors for new-onset atrial arrhythmias in patients with malignancies receiving antitumor therapy, and how does type 2 diabetes affect this risk?
Type 2 diabetes mellitus and anthracycline use synergistically increase the risk of new-onset atrial arrhythmias in cancer patients undergoing antitumor therapy.
Answers are grounded in this paper and cite their sources.
T2DM may warrant closer arrhythmia monitoring during cancer therapy; observational data leaves open targeted prevention trials.
Objective: Patients with malignancies and type 2 diabetes mellitus (T2DM) face heightened risks of cardiotoxicity from antitumor therapies, yet the interplay between diabetes, antitumor drugs, and atrial arrhythmias remains underexplored. This study investigates the incidence and risk factors of atrial arrhythmias in this high-risk population. Methods: In this retrospective cohort study, 171 patients with T2DM and malignancies receiving antitumor therapy at Zhejiang Hospital (January 2022-January 2024) were analyzed. Serial 12-lead electrocardiograms (ECGs) were performed pre- and post-chemotherapy cycles to detect new-onset atrial arrhythmias. Multivariate Cox regression identified risk factors, adjusting for age, hypertension, renal function, and cardiac biomarkers (troponin I, NT-proBNP). Subgroup analyses stratified by tumor type, diabetes duration, and drug class were conducted. Results: Atrial arrhythmias occurred in 10.5% of patients (18/171), with a significantly higher incidence in diabetics versus non-diabetics (18.4% vs. 4.2%, P=0.004). Advanced age (HR=10.25, 95% CI 1.01-104.56; P=0.049) and anthracycline use (HR=2.70, 95% CI 1.02-7.19; P=0.045) independently predicted arrhythmia risk. Diabetes duration ≥5 years (HR=2.85, 95% CI 1.22-6.70; P=0.016) and reduced eGFR (<60 mL/min/1.73m²; HR=2.58, 95% CI 1.04-6.39; P=0.039) further elevated risk. A synergistic interaction was observed between diabetes and anthracyclines (HR=3.95, 95% CI 1.58-9.85; P=0.002). Dynamic rises in NT-proBNP (≥50%) and troponin I (≥5 ng/L) emerged as strong predictors (HR=2.11 and 2.73, respectively; P<0.05). Conclusion: T2DM significantly amplifies atrial arrhythmia risk in cancer patients receiving antitumor drugs, particularly anthracyclines. Age, ischemic heart disease, and biomarker trends are critical risk indicators. Proactive ECG and biomarker monitoring, coupled with cardio-oncology collaboration, are essential for mitigating arrhythmia-related morbidity.
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Zhang et al. (2025) conducted a cohort in Malignant tumors and type 2 diabetes mellitus (n=171). Type 2 diabetes mellitus vs. Non-diabetic patients was evaluated on Incidence of new-onset atrial arrhythmias (HR 9.50, 95% CI 1.15-78.32, p=0.038). Type 2 diabetes mellitus increased the risk of new-onset atrial arrhythmias in cancer patients receiving antitumor therapy compared to non-diabetic patients.
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