Atrial fibrillation in patients with chronic lymphocytic leukemia (CLL)

Leuk Lymphoma. 2017 Jul;58(7):1630-1639. doi: 10.1080/10428194.2016.1257795. Epub 2016 Nov 25.

Abstract

Although preliminary data suggests that ibrutinib may increase risk of atrial fibrillation (AF), the incidence of AF in a general cohort of chronic lymphocytic leukemia (CLL) patients is unknown. We evaluated the prevalence of AF at CLL diagnosis and incidence of AF during follow-up in 2444 patients with newly diagnosed CLL. A prior history of AF was present at CLL diagnosis in 148 (6.1%). Among the 2292 patients without history of AF, 139 (6.1%) developed incident AF during follow-up (incidence approximately 1%/year). Older age (p < .0001), male sex (p = .01), valvular heart disease (p = .001), and hypertension (p = .04) were associated with risk of incident AF on multivariate analysis. A predictive model for developing incident AF constructed from these factors stratified patients into 4 groups with 10-year rates of incident AF ranging from 4% to 33% (p < .0001). This information provides context for interpreting rates of AF in CLL patients treated with novel therapies.

Keywords: Chronic lymphocytic leukemia; atrial fibrillation; ibrutinib; risk factors.

MeSH terms

  • Adenine / analogs & derivatives
  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / etiology*
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications*
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Piperidines
  • Prevalence
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrazoles / adverse effects
  • Pyrazoles / therapeutic use
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use
  • Risk Factors
  • Young Adult

Substances

  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • ibrutinib
  • Adenine