Atrial fibrillation in patients with chronic lymphocytic leukemia (CLL)

Abstract

Although preliminary data suggests that ibrutinib may increase risk of atrial fibrillation (AF), the incidence of AF in a general cohort of chronic lymphocytic leukemia (CLL) patients is unknown. We evaluated the prevalence of AF at CLL diagnosis and incidence of AF during follow-up in 2444 patients with newly diagnosed CLL. A prior history of AF was present at CLL diagnosis in 148 (6.1%). Among the 2292 patients without history of AF, 139 (6.1%) developed incident AF during follow-up (incidence approximately 1%/year). Older age (p < .0001), male sex (p = .01), valvular heart disease (p = .001), and hypertension (p = .04) were associated with risk of incident AF on multivariate analysis. A predictive model for developing incident AF constructed from these factors stratified patients into 4 groups with 10-year rates of incident AF ranging from 4% to 33% (p < .0001). This information provides context for interpreting rates of AF in CLL patients treated with novel therapies.

Keywords:

• Chronic lymphocytic leukemia
• atrial fibrillation
• risk factors
• ibrutinib

Acknowledgements

Dr. Shanafelt is a clinical scholar of the Leukemia and Lymphoma Society.

Funding support for this study was provided by Pharmacyclics. Drs. Shanafelt, Hallek, Parikh, Call, Kay, and Eichhorst have received research funding from Pharmacyclics/Janssen. Dr. Kay, Parikh, and Hallek have served as members of the Advisory Board and have received honoraria from of Pharmacyclics. Drs. Hallek, Eichhorst, and Goede have served as members of the Advisory Board and have received honoraria from Janssen.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2016.1257795.