Abstract 4369542: Impact of malignancy on the vascular outcomes in patients with atrial fibrillation.

Background: Malignancy is known to increase the risk of thromboembolic events and promote a hypercoagulable state, which may exacerbate vascular complications in patients with atrial fibrillation (AF). This study aims to examine the association between malignancy and adverse vascular outcomes in individuals with AF. Research Question: How does the presence of malignancy influence vascular outcomes in patients with atrial fibrillation? Methods: A retrospective analysis was conducted using data from the National Inpatient Sample (NIS) spanning 2018 to 2020. Adult patients (age >18 years) diagnosed with atrial fibrillation (AF) were categorized into two cohorts: those with and without concomitant malignancy. Multivariable logistic and linear regression models were utilized to assess clinical outcomes, adjusting for potential confounders. Outcomes were reported as adjusted odds ratios (aORs) and beta coefficients (B). Results: Between 2018-2020, a total of 8,689,195 hospitalizations for atrial fibrillation (AF) were identified, with 836,605 (9.63%) having concomitant malignancy. A higher proportion of males was observed among AF patients with malignancy (61%) compared to those without (48%). Malignancy was associated with increased odds of acute ischemic stroke (OR: 1.58, 95% CI: 1.30-1.88, p<0.001), venous thromboembolism (OR: 1.57, 95% CI: 1.53-1.62, p<0.001), and major bleeding (OR: 1.06, 95% CI: 1.04-1.08, p<0.001). However, it was not significantly associated with in-hospital mortality (OR: 1.02, p=0.20). Admissions with both AF and malignancy had shorter hospital stays (B: -0.26 days) and lower hospitalization costs (B: -$2,646) compared to those without malignancy. Conclusion: The presence of malignancy in AF significantly increases the odds of adverse thromboembolic complications. Implementing tailored treatment strategies can help reduce these risks and improve clinical outcomes in this high-risk group.