Atrial fibrillation (AFib) patients with a history of cancer may be less likely to see a cardiologist or fill anticoagulant prescriptions compared with AFib patients who never had cancer, according to a study published Oct. 8 in the Journal of the American College of Cardiology.

Wesley T. O'Neal, MD, MPH, et al., examined the relationship between early cardiology involvement after an AFib diagnosis in patients with a history of cancer and how that affected outcomes. They looked at over 380,000 AFib patients in the MarketScan database and found 17 percent had a history of cancer. Prostate and breast cancers were the most common types of cancer, and patients with a history of cancer were also older and more likely to have other cardiovascular conditions.

Results showed that patients with a history of cancer were less likely to see a cardiologist after AFib diagnosis and less likely to fill prescriptions for oral anticoagulants. Differences were similar when looking at active cancers vs. remote history of cancer. The researchers confirmed that a beneficial association existed between early cardiology involvement at the time of AFib diagnosis among patients with a history of cancer. After 1.1 years of follow up, cancer patients who did see a cardiologist were more likely to fill their prescriptions, showed a reduced risk of stroke and did not show an increased risk of bleeding. These patients were more likely to be hospitalized, which may be due to more aggressive treatments.

According to a related editorial comment, the number of cancer survivors in the U.S. is expected to increase from over 15 million to over 20 million by 2026, which will lead to an increased focus on addressing their long-term medical and psychosocial needs.

"The management of cancer patients must extend beyond their primary malignancy and will require an interdisciplinary approach from oncologists, primary care providers and other subspecialists," said Sean T. Chen, MD, an author of the editorial from Duke University Medical Center. "The increase in survivorship is a testament to the dramatic improvements in cancer therapy, but continued emphasis on a patient's diagnosis of cancer can shift significant attention away from other essential aspects of care."

Keywords: Atrial Fibrillation, Anticoagulants, Follow-Up Studies, Prostate, Stroke, Hemorrhage, Risk, Breast Neoplasms, Primary Health Care, Cardiotoxicity

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