Abstract 17218: Radiation Therapy is not Associated With Incident Atrial Fibrillation in Patients With Thoracic Cancer
Bibliographic record
Abstract
Introduction: Radiotherapy for thoracic cancer causes incidental cardiac exposure and increases risk of ischemic heart disease. Less clear is whether radiotherapy similarly increases risk of arrhythmias. Radiotherapy induces cardiac inflammation and fibrosis, which are risk factors for atrial fibrillation (AF). Hypothesis: In patients with thoracic tumors, radiotherapy is associated with incident AF. Methods: We conducted a retrospective study of electronic medical records (EMR) of patients who had a primary tumor of the breast, lung, mediastinum, or esophagus diagnosed between 1994 and 2014, did not have AF at time of diagnosis, and did not have previous thoracic radiotherapy. Patients were followed for incident AF until the end of the EMR or death. Incident AF was determined using a validated algorithm with a positive predictive value of 95.6%. After multiple imputation of missing variables, the association between radiotherapy and incident AF was assessed using Cox proportional hazards models. Results: 4163 patients were included in the analysis. Mean (SD) age was 61.2 (13.3) years and 71% were women; 600 underwent radiotherapy. After a median (25 th -75 th percentile) 796 (255-2032) days of follow-up, the incidence of AF was 6.8% with and 6.2% without radiotherapy (P=0.538). After adjustment for potential confounders, radiotherapy was not associated with incident AF [hazard ratio (HR): 1.02, 95% confidence interval: 0.72-1.44]. Age [HR (per year): 1.05 (1.04-1.06), P=6.0*10 -15 ], male sex [HR: 2.44 (1.80-3.30), P=9.5*10 -9 ], coronary artery disease [HR: 1.42 (1.06-1.92), P=0.02], hypertension [HR: 6.44 (2.04-20.3), P=0.001], and heart failure [HR: 3.20 (2.31-4.44), P=3.4*10 -12 ] were associated with incident AF. Among 3908 patients with unilateral breast or lung tumors, radiotherapy was not associated with incident AF [HR: 1.23 (0.79-1.92)] and tumor laterality did not modify the effect (P for interaction: 0.201). Conclusions: In this large retrospective cohort study, radiotherapy for thoracic tumors was not associated with incident AF. Rather, previously described AF risk factors were the most important drivers of AF risk. Larger studies with extended follow-up may further elucidate whether thoracic radiotherapy is a risk factor for AF.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".