Preexisting cardiovascular disease and inpatient arrhythmias after autologous stem cell transplantation for multiple...

Area of Science:

• Hematology
• Cardiology
• Oncology

Background:

• Autologous stem cell transplantation (ASCT) is standard for transplant-eligible multiple myeloma (MM).
• Limited data exist on inpatient arrhythmias in MM-ASCT patients with pre-existing cardiovascular disease (CVD).
• This study evaluates new-onset inpatient arrhythmias based on pre-existing CVD status.

Purpose of the Study:

• To determine the incidence of new-onset inpatient arrhythmias in multiple myeloma patients undergoing ASCT.
• To assess the association between pre-existing cardiovascular disease and the occurrence of these arrhythmias.
• To analyze secondary outcomes such as length of stay, hospital charges, and discharge disposition.

Main Methods:

• Analysis of the National Inpatient Sample (2016-2022) of adult MM-ASCT hospitalizations.
• Identification of patients with pre-existing CVD (coronary artery disease, atrial fibrillation, valvular disease, etc.).
• Use of Firth's penalized logistic regression and LASSO regression for analysis.

Main Results:

• 12% of MM-ASCT hospitalizations (n=58) had pre-existing CVD.
• New-onset inpatient arrhythmias occurred in 16% of hospitalizations.
• Arrhythmias were significantly more frequent in patients with pre-existing CVD (66.7% vs 2.2%, P < 0.001).

Conclusions:

• New-onset inpatient arrhythmias are more frequent in MM-ASCT patients with pre-existing CVD.
• These findings suggest a need for closer cardiac monitoring in this patient population.
• Further validation in larger, clinically adjudicated cohorts is warranted.