Understanding Mortality Patterns in Elderly Cancer Patients with Atrial Fibrillation: A Comprehensive Data Analysis.

Muhammad Abdullah Naveed, Sivaram Neppala, Shehroze Tabassum, Ahila Ali, Himaja Dutt Chigurupati, Muhammad Omer Rehan, Rabia Iqbal, Bazil Azeem, Hamza Naveed, Mushood Ahmed, Jamal Rana, Bilal Munir
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Abstract

Background: Atrial Fibrillation (AF) among patients with cancer is a significant health concern for older adults in the United States. This study analyzes trends and demographic disparities in mortality rates related to AF in patients with cancer aged 65+.

Methods: The CDC WONDER database was used to analyze Age-adjusted mortality rates (AAMRs) for to AF in patients with cancer (ICD-10 I48, C00- C97) from 1999 to 2023, stratified by sex, race, geography, and metropolitan status. Average Annual Percentage Changes (AAPCs) and Annual Percentage Changes (APCs) per 100,000 with 95% confidence intervals (CI) calculated using Joinpoint regression.

Results: From 1999 to 2023, AF in patients with cancer caused 421,247 deaths among U.S. adults 65+. The overall AAMR rose from 24.1 in 1999 to 61.1 in 2023, with a 3.92 AAPC (95% CI: 3.81 to 4.05). AAMR increased significantly from 1999 to 2018 (APC: 3.12), surged from 2018 to 2021 (APC: 10.93), then rose slightly until 2023 (APC: 1.40), all p <0.01. From 1999 to 2023, Men had higher AAMRs than women (53.8 vs. 27.2) while NH Whites had the highest AAMRs (42.2), followed by NH Blacks (23.1). Vermont has the highest AAMR (60.0), Nevada the lowest (17.3), and the Western region had the highest AAMR (40.8), while rural areas had slightly higher AAMRs than urban areas (39.1 vs 34.8).

Conclusion: The AAMR for AF in patients with cancer in the U.S. has doubled over the past two decades, particularly during the COVID-19 pandemic. These findings highlight the urgent need for targeted interventions and enhanced access to care.

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