Abstract Body: Background: Cancer is associated with an increased risk for atrial fibrillation. However, there are no existing data supporting an independent relationship between cancer and atrial cardiopathy, another atrial pathology associated with increased acute ischemic stroke (AIS) risk. We investigated the relationship between atrial cardiopathy and cancer among patients with AIS.

Methods: We conducted a retrospective cross-sectional study among consecutive patients hospitalized with AIS at a quaternary care center in New York City from 2011 through 2016. The study exposure was active cancer. The study outcome was atrial cardiopathy, defined as a left atrial volume index ≥35 mL/m² as determined by echocardiography. We used multivariable logistic regression, adjusting for relevant confounders, to evaluate the relationship between active cancer and atrial cardiopathy. We performed a subgroup analysis among patients with embolic stroke of undetermined source (ESUS).

Results: The final cohort included 1104 patients with AIS, of whom 10% had active cancer and 47% had atrial cardiopathy. Patients with atrial cardiopathy, compared to those without, were older (median age, 77 years versus 68 years), and more frequently had hypertension, coronary disease, and atrial fibrillation. Active cancer was present in 9.6% of patients with atrial cardiopathy (n=50/520) and 10.4% of patients without (n=61/584). In multivariable models, there was no association between active cancer and atrial cardiopathy among the overall AIS cohort (adjusted odds ratio, 0.91; 95% confidence interval, 0.60-1.37) nor in patients with ESUS (adjusted odds ratio, 0.64; 95% confidence interval, 0.30-1.36).

Conclusion: When defining atrial cardiopathy according to left atrial volume, we did not find an association between cancer and atrial cardiopathy in patients with AIS, including among patients with ESUS. Future studies, evaluating other atrial cardiopathy biomarkers and settings, are needed to further investigate any potential link between cancer and atrial cardiopathy.