1. Predictors of atrial fibrillation in ibrutinib-treated CLL patients: a prospective study
- Author
-
Gianluigi Reda, Veronica Mattiello, Diana Giannarelli, Ramona Cassin, Tatiana Tonella, Bruno Fattizzo, F. Massari, and Agostino Cortelezzi
- Subjects
Male ,Cancer Research ,Chronic lymphocytic leukaemia ,medicine.medical_treatment ,Amiodarone ,Cardioversion ,chemistry.chemical_compound ,0302 clinical medicine ,Piperidines ,Agammaglobulinaemia Tyrosine Kinase ,Medicine ,Prospective Studies ,Prospective cohort study ,Letter to the Editor ,Aged, 80 and over ,Framingham Risk Score ,medicine.diagnostic_test ,Ibrutinib ,Atrial fibrillation ,Hematology ,lcsh:Diseases of the blood and blood-forming organs ,Middle Aged ,Protein-Tyrosine Kinases ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Cardio-oncology ,Oncology ,Echocardiography ,030220 oncology & carcinogenesis ,Cardiology ,Female ,medicine.drug ,medicine.medical_specialty ,Hemorrhage ,lcsh:RC254-282 ,03 medical and health sciences ,Internal medicine ,Humans ,Risk factor ,Molecular Biology ,Protein Kinase Inhibitors ,Aged ,business.industry ,lcsh:RC633-647.5 ,Adenine ,Reproducibility of Results ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,Pyrimidines ,chemistry ,Pyrazoles ,business ,Electrocardiography ,030215 immunology - Abstract
Background Ibrutinib is an oral irreversible inhibitor of Bruton’s tyrosine kinase, indicated for the treatment of chronic lymphocytic leukaemia. The drug is generally well tolerated; however, not infrequent side effects are reported, with the major two being bleeding and ibrutinib-related atrial fibrillation. Atrial fibrillation pathogenesis in this setting is not completely clear, and no prospective studies have evaluated the impact of previous cardiologic history and baseline characteristics. Methods We prospectively performed cardiologic assessment in 43 CLL patients before starting ibrutinib therapy. Cardiologic workup included comorbidity collection and electrocardiographic and echocardiographic baseline evaluation. Results After a median observation of 8 months, seven patients developed atrial fibrillation (16.3%). Cases developing atrial fibrillation were all elderly males (p = 0.04), and mostly with a history of previous arterial hypertension (p = 0.009). Atrial fibrillation occurrence also correlated with the presence of one or more pre-existent cardiologic comorbidities (p = 0.03), with a higher atrial fibrillation risk score (calculated with comorbidities and cardiologic risk factor evaluation p
- Published
- 2018