Abstract / Summary
Abstract Introduction Multiple myeloma (MM) is a hematological malignancy with a median age at diagnosis of 72 years. Consequently, cardiovascular comorbidity is a concern. Using Swedish population-based registries, we aim to describe cardiac comorbidities among patients at time of MM diagnosis, the incidence of new cardiovascular events (CVE) at 2-year follow-up and the risk of death, in comparison with matched controls. Material and methods All MM patients (n=8 672) in the Swedish myeloma registry (SMR) diagnosed 2008-2021 were included. Matched controls (n=34 561) and data on cardiovascular disease (CVD) and CVE were collected from nationwide registries. Differences in incidence and mortality were evaluated with chi-square tests and Cox regression. Ethical consent was obtained from the Swedish Ethical Review Board. Results At time of MM diagnosis, 45.8% of the MM patients had a registered CVD vs 35.7% of the controls, p<0.0001. The most frequent comorbidities were hypertension and atrial fibrillation (AF) among both patients and controls; hypertension 32.5% vs 23.3%, p<0.0001 and AF 11.1% vs 9.1%, p<0.0001. At 2-year follow-up, 17.7% of patients had AF vs 8.5% of controls, p<0.0001. Occurrence of AF in patients >80 years was substantial, 30.1%, vs 17.7%, p<0.0001. Among patients with no prior CVD, new-onset CVE was seen among 43%. Patients with CVE at 2-year follow-up had an increased risk of death vs patients without a CVE, HR 1.30 (95% CI 1.21-1.40, p<0.0001). Conclusion Almost 50% of patients had a CVD at the time of MM diagnosis. Among patients >80 years, 30% had a diagnosis of AF at 2-year follow-up. Almost half of MM patients with no CVD at time of MM diagnosis, had a CVE at 2-year follow-up. Among MM patients, CVE was associated with inferior survival, calling for awareness and guidelines for management of CVD among MM patients.