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Coexisting atrial fibrillation and cancer: time trends and associations with mortality in a nationwide Dutch study
European Heart Journal ( IF 37.6 ) Pub Date : 2024-04-15 , DOI: 10.1093/eurheartj/ehae222
Qingui Chen 1 , Nienke van Rein 1, 2 , Tom van der Hulle 3 , Julius C Heemelaar 4, 5 , Serge A Trines 4 , Henri H Versteeg 6 , Frederikus A Klok 6 , Suzanne C Cannegieter 1, 6
Affiliation  

Background and Aims Coexisting atrial fibrillation (AF) and cancer challenge the management of both. The aim of the study is to comprehensively provide the epidemiology of coexisting AF and cancer. Methods Using Dutch nationwide statistics, individuals with incident AF (n = 320 139) or cancer (n = 472 745) were identified during the period 2015–19. Dutch inhabitants without a history of AF (n = 320 135) or cancer (n = 472 741) were matched as control cohorts by demographic characteristics. Prevalence of cancer/AF at baseline, 1-year risk of cancer/AF diagnosis, and their time trends were determined. The association of cancer/AF diagnosis with all-cause mortality among those with AF/cancer was estimated by using time-dependent Cox regression. Results The rate of prevalence of cancer in the AF cohort was 12.6% (increasing from 11.9% to 13.2%) compared with 5.6% in the controls; 1-year cancer risk was 2.5% (stable over years) compared with 1.8% in the controls [adjusted hazard ratio (aHR) 1.52, 95% confidence interval (CI) 1.46–1.58], which was similar by cancer type. The rate of prevalence of AF in the cancer cohort was 7.5% (increasing from 6.9% to 8.2%) compared with 4.3% in the controls; 1-year AF risk was 2.8% (stable over years) compared with 1.2% in the controls (aHR 2.78, 95% CI 2.69–2.87), but cancers of the oesophagus, lung, stomach, myeloma, and lymphoma were associated with higher hazards of AF than other cancer types. Both cancer diagnosed after incident AF (aHR 7.77, 95% CI 7.45–8.11) and AF diagnosed after incident cancer (aHR 2.55, 95% CI 2.47–2.63) were associated with all-cause mortality, but the strength of the association varied by cancer type. Conclusions Atrial fibrillation and cancer were associated bidirectionally and were increasingly coexisting, but AF risk varied by cancer type. Coexisting AF and cancer were negatively associated with survival.

中文翻译:


共存的心房颤动和癌症:荷兰全国研究中的时间趋势及其与死亡率的关联



背景和目标 心房颤动 (AF) 和癌症共存对两者的治疗提出了挑战。该研究的目的是全面提供共存 AF 和癌症的流行病学信息。方法 使用荷兰全国统计数据,确定了 2015-19 年期间发生 AF (n = 320 139) 或癌症 (n = 472 745) 的个体。无 AF 病史 (n = 320 135) 或癌症病史 (n = 472 741) 的荷兰居民根据人口统计学特征作为对照队列进行匹配。确定了基线时癌症/房颤的患病率、癌症/房颤诊断的 1 年风险及其时间趋势。通过使用时间依赖性 Cox 回归来估计癌症/房颤诊断与房颤/癌症患者全因死亡率的关联。结果 AF 队列中癌症患病率为 12.6%(从 11.9% 增加至 13.2%),而对照组为 5.6%; 1 年癌症风险为 2.5%(多年稳定),而对照组为 1.8% [调整后风险比 (aHR) 1.52,95% 置信区间 (CI) 1.46–1.58],癌症类型相似。癌症队列中 AF 的患病率为 7.5%(从 6.9% 增至 8.2%),而对照组为 4.3%; 1 年 AF 风险为 2.8%(多年稳定),而对照组为 1.2%(aHR 2.78,95% CI 2.69–2.87),但食管癌、肺癌、胃癌、骨髓瘤和淋巴瘤与较高的 AF 风险相关。 AF 的危害高于其他癌症类型。 AF 发生后诊断的癌症(aHR 7.77,95% CI 7.45–8.11)和癌症发生后诊断的 AF(aHR 2.55,95% CI 2.47–2.63)均与全因死亡率相关,但关联强度因癌症而异。癌症类型。 结论 心房颤动和癌症是双向相关的,并且越来越多地共存,但房颤风险因癌症类型而异。共存的房颤和癌症与生存呈负相关。
更新日期:2024-04-15
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