TY - JOUR
T1 - Atrial fibrillation is associated with increased in-hospitality mortality during Chimeric Antigen Receptor T-cell therapy hospitalizations
T2 - a retrospective cohort study in the United States
AU - Baral, Nischit
AU - Karki, Nabin R.
AU - Ladin, Daniel A.
AU - Zaghlol, Raja
AU - Ibrahim, Mahmoud
AU - Rabadi, Alexander
AU - Elajami, Tarec K.
AU - Mechanic, Olivia
AU - Kunadi, Arvind
AU - Mitchell, Joshua D.
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Chimeric Antigen Receptor (CAR) T-cell therapy (CAR-T) has emerged as a promising treatment for specific hematological malignancies. While some studies suggest an association between CAR-T and atrial fibrillation (AF), more data are needed on the association of AF with CAR-T outcomes. Methods: This retrospective cohort study utilized the National Inpatient Sample (NIS) 2017–2020 to explore in-hospital outcomes in cancer patients with AF while undergoing CAR-T. Comparisons were drawn between patients with and without AF during the hospitalization, assessing various parameters including mortality rates, length of hospital stay, and occurrences of acute heart failure, pulmonary edema, and gastrointestinal (GI) bleeding. Results: Of the 236,270 cancer-related hospitalizations, 1,030 cases (0.44%) received CAR-T. The average age of CAR-T recipients was 55.6 years ± 18.1 years, and females constituted 40.5% of the total CAR-T recipients. Of the 1030 patients receiving CAR-T, 97 (9.4%) had an associated diagnosis of AF during their hospitalization. A multivariable logistic regression analysis, adjusted for age, sex, race, comorbidity, and income, revealed that hospitalized cancer patients who underwent CAR-T therapy with AF had increased odds of in-hospital mortality (adjusted odds ratio, aOR: 3.87), acute pulmonary edema (aOR: 3.29), GI bleeding (aOR: 5.46), acute heart failure (aOR: 10.2), and extended hospital stays (Beta coefficient: 0.18) compared to hospitalizations with CAR-T but without AF. Similar results were observed in two sensitivity analyses: one limited to patients with diffuse B-cell lymphoma, and another excluding patients who had sepsis or respiratory failure while receiving CAR-T therapy. Conclusions: In cancer patients receiving CAR-T, inpatient AF is independently associated with a higher risk of in-hospital mortality, acute pulmonary edema, gastrointestinal bleeding, acute heart failure, and prolonged hospitalization.
AB - Background: Chimeric Antigen Receptor (CAR) T-cell therapy (CAR-T) has emerged as a promising treatment for specific hematological malignancies. While some studies suggest an association between CAR-T and atrial fibrillation (AF), more data are needed on the association of AF with CAR-T outcomes. Methods: This retrospective cohort study utilized the National Inpatient Sample (NIS) 2017–2020 to explore in-hospital outcomes in cancer patients with AF while undergoing CAR-T. Comparisons were drawn between patients with and without AF during the hospitalization, assessing various parameters including mortality rates, length of hospital stay, and occurrences of acute heart failure, pulmonary edema, and gastrointestinal (GI) bleeding. Results: Of the 236,270 cancer-related hospitalizations, 1,030 cases (0.44%) received CAR-T. The average age of CAR-T recipients was 55.6 years ± 18.1 years, and females constituted 40.5% of the total CAR-T recipients. Of the 1030 patients receiving CAR-T, 97 (9.4%) had an associated diagnosis of AF during their hospitalization. A multivariable logistic regression analysis, adjusted for age, sex, race, comorbidity, and income, revealed that hospitalized cancer patients who underwent CAR-T therapy with AF had increased odds of in-hospital mortality (adjusted odds ratio, aOR: 3.87), acute pulmonary edema (aOR: 3.29), GI bleeding (aOR: 5.46), acute heart failure (aOR: 10.2), and extended hospital stays (Beta coefficient: 0.18) compared to hospitalizations with CAR-T but without AF. Similar results were observed in two sensitivity analyses: one limited to patients with diffuse B-cell lymphoma, and another excluding patients who had sepsis or respiratory failure while receiving CAR-T therapy. Conclusions: In cancer patients receiving CAR-T, inpatient AF is independently associated with a higher risk of in-hospital mortality, acute pulmonary edema, gastrointestinal bleeding, acute heart failure, and prolonged hospitalization.
KW - Atrial fibrillation
KW - Cancer
KW - Cardiovascular disease
KW - Chimeric Antigen Receptor T-cell therapy
KW - Cohort Study
KW - In-hospital Mortality
UR - https://www.scopus.com/pages/publications/105010147787
U2 - 10.1186/s40959-025-00334-5
DO - 10.1186/s40959-025-00334-5
M3 - Article
C2 - 40611323
AN - SCOPUS:105010147787
SN - 2057-3804
VL - 11
JO - Cardio-Oncology
JF - Cardio-Oncology
IS - 1
M1 - 60
ER -