Association of atrial fibrillation and various cancer subtypes

AimThis research was conducted to evaluate the mortality outcome of cancer patients with new-onset atrial fibrillation. We also aimed to assess if there was any confounding relation between the mortality of these patients and surgical intervention.Materials and MethodsA systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 7 February 2022. All statistical analyses were conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. Only those studies that involved cancer patients without pre-existing atrial fibrillation were selected, and mortality rate was compared between the patients who developed atrial fibrillation and those who did not. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the odds ratio (OR) and the corresponding 95% confidence interval (CI).ResultsEighteen studies were selected for meta-analysis. Statistical analysis showed that the cancer patients who subsequently developed atrial fibrillation had a significantly higher mortality rate as compared to those who did not (OR = 1.90 [1.65, 2.19]; p < 0.00001; I2 = 100%). We also separately analyzed the mortality risk in the surgery group and the non-surgery group. Statistical analysis showed that there was significantly higher mortality rate associated with new-onset atrial fibrillation in cancer patients in the surgery group (OR= 3.68 [2.29, 5.94]; p < 0.00001; I2 = 61%) as well as in the non-surgery group (OR = 1.64 [1.39, 1.93]; p < 0.00001; I2 = 100%).ConclusionCancer patients, who subsequently developed atrial fibrillation, had a higher mortality rate as compared to those cancer patients who did not develop atrial fibrillation. A higher mortality rate was seen in both surgical and non-surgical subgroups. This implies that extra care and specific measures must be taken in the management of cancer patients with new-onset atrial fibrillation.

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“…Table 4 provides the basic characteristics of included studies ( 14 – 31 ). Our analysis included 18 published studies.…”

Section: Resultsmentioning

confidence: 99%

“…Out of the 18 studies, 15 studies have a low risk of bias ( 15 – 23 , 25 , 27 – 31 ), two studies have a moderate risk of bias ( 14 , 26 ), and one study has a high risk of bias ( 24 ).…”

Section: Resultsmentioning

confidence: 99%

Higher Mortality Associated With New-Onset Atrial Fibrillation in Cancer Patients: A Systematic Review and Meta-Analysis

Murtaza

Baig

Ahmed

et al. 2022

Front. Cardiovasc. Med.

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“…Age is a known independent risk factor for arrhythmias,21 22 and in this population of patients, many have underlying cardiovascular diseases 8. About 63% of patients with newly diagnosed MM were found to have cardiac events prior to diagnosis with arrhythmia being most frequent 23.…”

Section: Discussionmentioning

confidence: 99%

Burden of arrhythmias and predictors of mortality among multiple myeloma patients with arrhythmias

Balogun

Jackson

Oyenuga

et al. 2022

Journal of Investigative Medicine

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Arrhythmias are a major cardiac complication reported among patients with multiple myeloma (MM), but these have not been further characterized in this population. We explored the prevalence of arrhythmias and examined the predictors of mortality among patients with MM with arrhythmias. The National Inpatient Sample data collected between 2016 and 2018 were used to conduct retrospective analyses. Multivariable logistic regression analyses were done to examine the predictors of mortality among patients with MM with arrhythmias. 16.9% of patients with MM reported a diagnosis of any arrhythmias and 70.7% of these were atrial fibrillation. Patients aged 70 years and above had 21% lower odds (adjusted OR (AOR): 0.79; 95% CI: 0.68 to 0.92) of inpatient mortality relative to younger patients. Those in the non-Hispanic black, Hispanic, and non-Hispanic other category were 1.38 (95% CI: 1.16 to 1.64), 1.53 (95% CI: 1.19 to 1.97), and 1.69 (95% CI: 1.29 to 2.21) times more likely to die during hospitalization compared with their counterparts who were non-Hispanic whites. Relative to patients with MM who were on Medicare, those on private (AOR: 1.28; 95% CI: 1.06 to 1.54) and other insurance types (AOR: 1.78; 95% CI: 1.23 to 2.58) had higher odds of mortality. Other predictors of inpatient mortality were elective admission (AOR: 0.67; 95% CI: 0.52 to 0.85) and Charlson comorbidity indices between 5–7 (AOR: 1.23; 95% CI: 1.07 to 1.41) and ≥8 (AOR: 1.45; 95% CI: 1.21 to 1.73) compared with comorbidity indices between 0 and 4. Our study adds to the body of knowledge on the need for proper diagnosis and management of cardiac arrhythmias in patients with MM. Research is needed to further assess the time of arrhythmia diagnosis and its impact on health outcomes among patients with MM.

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“…Table 1 summarizes the main characteristics of the included studies. Seventeen were retrospective cohort studies (7, 9-11, 13, 14, 31, 39, 40, 44-46), 5 were case-control studies (8,12,15,41,43), and 1 was a cross-sectional study (42). The follow-up time ranged from 0.24 to 19.1 years.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Seventeen studies reported the prevalence or incidence of atrial fibrillation (7-12, 14, 15, 39-47), 5 studies reported an association between atrial fibrillation and breast cancer (16)(17)(18)(19)(20), 5 studies reported an association between breast cancer and atrial fibrillation (7, 10,11,13,14) and 2 studies reported an association between atrial fibrillation and all-cause mortality in patients with breast cancer (11,41). Overall, these studies were published between 2008 and 2021, the sample sizes ranged from 86 to 1,122,100 with a total of 8,537,551 individuals, nine studies were from North America (the US and Canada) (7,8,11,15,16,20,(39)(40)(41), 7 studies were from Europe (9,10,12,18,19,44,46), and 7 studies were from Asia (13,14,17,42,43,45,47). The mean age varied from 51.9 to 78 years.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Atrial fibrillation and breast cancer—Vicious twins? A systematic review and meta-analysis

Yao

Hu²,

Liu³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundEpidemiological studies suggest a bidirectional association between atrial fibrillation and breast cancer. This study aimed to conduct a meta-analysis to elucidate the prevalence of atrial fibrillation among breast cancer patients, and the bidirectional association between atrial fibrillation and breast cancer.MethodsPubMed, the Cochrane Library, and Embase were searched to identify studies reporting the prevalence, incidence, and bidirectional association between atrial fibrillation and breast cancer. The study was registered with PROSPERO (CRD42022313251). Levels of evidence and recommendations were assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsTwenty-three studies (17 retrospective cohort studies, 5 case-control studies and 1 cross-sectional study) involving 8,537,551 participants were included. Among patients with breast cancer, the prevalence of atrial fibrillation was 3% (11 studies; 95% CI: 0.6 to 7.1%) and the incidence was 2.7% (6 studies; 95% CI: 1.1 to 4.9%). Breast cancer was associated with increased risk of atrial fibrillation (5 studies; hazard ratio [HR]: 1.43, 95% CI: 1.12 to 1.82, I2 = 98%). Atrial fibrillation was also significantly associated elevated risk of breast cancer (5 studies HR: 1.18, 95% CI: 1.14 to 1.22, I2 = 0%). Grade assessment shown low certainty of the evidence for the risk of atrial fibrillation and moderate certainty of the evidence for the risk of breast cancer.ConclusionAtrial fibrillation is not uncommon in patients with breast cancer and vice versa. There is a bidirectional association between atrial fibrillation (low certainty) and breast cancer (moderate certainty).

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Association of atrial fibrillation and various cancer subtypes

Cited by 12 publications

References 24 publications

Higher Mortality Associated With New-Onset Atrial Fibrillation in Cancer Patients: A Systematic Review and Meta-Analysis

Higher Mortality Associated With New-Onset Atrial Fibrillation in Cancer Patients: A Systematic Review and Meta-Analysis

Burden of arrhythmias and predictors of mortality among multiple myeloma patients with arrhythmias

Atrial fibrillation and breast cancer—Vicious twins? A systematic review and meta-analysis

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