128 Differences in patient characteristics and cardiac arrhythmias in adults with benign vs. malignant neoplasm of the heart; an analysis from the 2016–2020 national inpatient sample
IntroductionWhile cardiac neoplasms can disrupt conduction pathways, events of arrhythmias among patients with benign neoplasm of the heart (BNH) and malignant neoplasm of the heart (MNH) are not well reported. We aim to assess patient characteristics and odds of cardiac arrhythmias between BNH and MNH.MethodsRecords of adults with BNH or MNH were extracted from the 2016–2020 National Inpatient Sample using relevant ICD-10 codes. Differences in various characteristics, presence of cardiac arrhythmias and outcomes were explored.Results23,450 patients diagnosed with a cardiac neoplasm were included. 21,200 (90.4%) had a recorded diagnosis of BNH, while 2,250 (9.6%) had a diagnosis for MNH. BNH cases were older (65.07 vs 52.15, p<0.01), consisted mostly of patients of female sex (63.5% BNH vs 48.2% MNH, p<0.01) and were more comorbid, with significantly higher proportion of patients with cirrhosis, diabetes, hypertension, peripheral vascular disease, smoking, obesity, chronic kidney disease, alcohol abuse, drug abuse, and lipid disorder compared to those with MNH (all p=<0.001). While the majority of BNH cases were covered by Medicare, Private insurance forms were mostly used by MNH patients. Despite BNH having higher proportions of comorbidities, a higher mean Charlson Comorbidity Index (CCI) score was noted among the MNH cohort. (2.71 BNH vs 5.23 MNH, p<0.01) After adjusting for confounding factors, BNH patients had higher odds of reporting ventricular tachycardia (aOR 1.58 95% CI 1.17–2.14, p=0.003), while showing reduced odds of events for atrial flutter (aOR 0.51 95% CI 0.44–0.61, p<0.001). The BNH cohort also had reduced odds of adverse outcomes of cardiogenic shock (aOR 0.377, 95% CI 0.306–0.466, p<0.001), acute kidney injury (AKI) (aOR 0.629, 95% CI 0.553–0.716, p<0.001), and death (aOR 0.200, 95% CI 0.166–0.241, p<0.001) than those with MNH (table 1).ConclusionWhile patients with BNH were older and had higher a proportion of comorbidities, they reported reduced odds of atrial flutter and better overall outcomes, but higher odds of ventricular tachycardia. 128 Table 1aPatient Characteristics and differences between cases of benign heart neoplasm versus malignant heart neoplasm among adults Benign Heart Neoplasm (n=21200) (%) Malignant Heart Neoplasm (n=2250) (%) p-value Mean Age (Years) 65.07 52.15 <0.01 Female 63.5 48.2 <0.01 Comorbidities Cirrhosis 2.0 1.1 <0.01 Diabetes 29.4 18.0 <0.01 Hypertension 42.1 26.4 <0.01 Chronic Kidney Disease 19.7 8.2 <0.01 Lipid Disorder 48.9 28.4 <0.01 Mean Charlson Comorbidity Index (CCI) score 2.71 5.23 <0.01 Outcomes Cardiogenic Shock 2.2 6.9 <0.01 Acute Kidney Injury 17.3 18.0 0.412 Death 2.6 10.3 <0.01 128 Table 1bAdjusted odds ratio for presence of various cardiac arrhythmias and outcomes with Benign neoplasm of the heart as compared to those with Malignant neoplasm of the heart (reference) p-value aOR Lower 95% CI Upper 95% CI Atrial Fibrillation 0.315 1.057 0.948 1.179 Supraventricular Tachycardia 0.078 0.821 0.659 1.022 Ventricular Tachycardia 0.003 1.582 1.170 2.137 Ventricular Fibrillation 0.416 0.864 0.607 1.229 Atrial Flutter <0.001 0.513 0.435 0.605 Complete AV Block 0.615 0.919 0.662 1.276 Cardiogenic Shock <0.001 0.377 0.306 0.466 Acute Kidney Injury <0.001 0.629 0.553 0.716 Death <0.001 0.200 0.166 0.241 128 Figure 1Adjusted odds ratio for presence of various cardiac arrhythmias and complications in patients with Benign neoplasm of heart as compared to those with Malignant neoplasm of the heart(reference)Conflict of InterestNone
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