Atrial fibrillation mortality among patients with neoplasms: National trends and deep learning forecast through 2038.

Abstract

e24027 Background: Atrial fibrillation (AFib) is the most common cardiac arrhythmia globally and has emerged as a prevalent cardiovascular comorbidity in patients with neoplasms. Although prior studies have reported an association between AFib and neoplastic diseases, national trends in AFib-related mortality within this population remain poorly characterized. Methods: This population-based retrospective study utilized CDC WONDER mortality data. Decedents with cardiovascular disease listed as the underlying cause of death and with listed diagnoses of AFib and neoplasms were included. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population. Temporal trends were assessed using joinpoint regression to identify significant inflection points and estimate annual percent changes (APCs). GRU-based deep learning models were used to forecast mortality through 2038. Results: Among 478,881 deaths, AFib-related mortality in individuals with neoplasms increased from 4.3 per 100,000 in 1999 to 11.0 in 2022 (APC: 3.93%; 95% CI: 3.49–4.37; p < 0.00001). Significant joinpoints were identified in 2014, 2018, and 2021, with the steepest APC of 10.24% observed between 2018 and 2021. Mortality was higher in males but rose similarly across both sexes. Racial disparities were evident, with White and Black individuals exhibiting the highest AAMRs, while Hispanic individuals experienced the fastest rate of increase (AAPC: 5.05%). The majority of deaths occurred in medical facilities (37.7%) and 94.3% of AFib-related deaths were attributable to malignant neoplasms.. Forecasting analysis projected a 27% rise in AAMR by 2038, with upward trends across all sex and racial groups. Conclusions: AFib-related mortality among individuals with neoplasms has nearly tripled over the past two decades, marked by distinct periods of acceleration, persistent demographic disparities, and concerning future projections. These trends may be related to prolonged survival among cancer patients, improvements in overall survival, and the increasing number and complexity of oncologic and cardiovascular medications.