Atrial Cardiomyopathy Predicts Worse Outcome in Patients With Lung Cancer

Mengdi Ren; Yuyan Ma; Meng Wei; Yuye Ning; Hui Liu; Xue Shi; Yu Yao; Fengwei Guo

doi:10.3389/fcvm.2022.932044

Atrial Cardiomyopathy Predicts Worse Outcome in Patients With Lung Cancer

Front Cardiovasc Med. 2022 Jul 1:9:932044. doi: 10.3389/fcvm.2022.932044. eCollection 2022.

Authors

Mengdi Ren¹, Yuyan Ma¹, Meng Wei², Yuye Ning³, Hui Liu⁴, Xue Shi⁴, Yu Yao¹, Fengwei Guo⁵

Affiliations

¹ Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
² Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
³ The Second Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, China.
⁴ Biobank, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
⁵ Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Abstract

Background: Reports of the clinical outcomes associated with the co-occurrence of atrial cardiomyopathy (ACM) and lung cancer (LC) are limited.

Objectives: This study aims to investigate the influence of ACM on the prognosis of LC patients and related clinical determinants.

Methods: Newly diagnosed LC patients from January 1st, 2015, to December 31st, 2020, were retrospectively enrolled at the First Affiliated Hospital of Xi'an Jiaotong University. The demographics and overall survival (OS) of the patients with or without ACM were compared. The survival rate was analyzed using the Kaplan-Meier method and multivariate Cox regression analysis. Binary logistic regression analysis was used to determine the risk factors for ACM.

Results: A total of 306 patients (65.04 ± 10.30 years of age, 72.88% male) were analyzed. The prevalence of ACM in the non-small cell lung cancer (241, 78.76%) and small cell lung cancer (65, 21.24%) population was not statistically different. Overall, 53 (17.32%) LC patients had coexisting ACM. ACM patients were older (69 vs. 64, p = 0.0013) and had higher D-dimer levels (1.0 vs. 0.6, p = 0.001), lower serum calcium levels (2.23 vs. 2.31, p = 0.001), lower left ventricular ejection fraction (LVEF) values (67% vs. 69%, p = 0.036) and had more frequent coronary comorbidity disease (16.98% vs. 8.82%, p = 0.031). The median OS for patients with or without ACM was 15 months and 25 months, respectively (p = 0.018). Coexisting ACM compared to non-ACM was associated with worse OS in patients with LC (HR = 1.543, 95% CI: 1.042-2.283, p = 0.030).

Conclusion: Coexisting ACM is associated with undesirable survival outcomes in patients with LC. These findings could help us to better understand the cardiac burden in these patients and provide additional risk stratification for them.

Keywords: atrial cardiomyopathy; atrial fibrillation; ischemic stroke; lung cancer; oncocardiology.