Guzzetti Stefano, Costantino Giorgio, Vernocchi Alessandra, Sada Simona, Fundarò Camilla
Medicina Interna I, Ospedale Luigi Sacco, Polo Universitario dell'Università degli Studi di Milano, Via GB Grassi, 74, 20157, Milan, Italy.
Intern Emerg Med. 2008 Sep;3(3):227-31. doi: 10.1007/s11739-008-0124-4. Epub 2008 Mar 5.
Aim of the present study was to assess the prevalence of atrial fibrillation (AF) in patients with two different types of cancer. Recent epidemiologic and clinical studies support the hypothesis that AF is promoted and maintained by a broad spectrum of modulating factors. A total of 2,339 patients admitted to the Surgery Department of "Luigi Sacco Hospital, Milan," over the period 1987-2004 were eligible for the study. One thousand three hundred and seventeen patients were admitted consecutively with a first diagnosis of colorectal or breast cancer (cases). The remaining 1,022 were patients admitted to undergo non-neoplastic surgery (controls). Routine pre-surgery electrocardiogram available in patient charts was analysed by a cardiologist who was not aware of the present study to evaluate the presence of atrial fibrillation or other arrhythmias. Overall, AF was present in 3.6% cases and 1.6% controls. This corresponded to at least two times higher likelihood of having AF in cases compared to controls. Prevalence of AF increased with age both in cases and controls. Our study describes an increased prevalence of AF in two different types of cancer. Autonomic, endocrine, coagulation, and inflammatory alterations were previously described in both AF and cancer, and can provide the physiopathological basis to our clinical observation.
本研究的目的是评估两种不同类型癌症患者中房颤（AF）的患病率。近期的流行病学和临床研究支持这样一种假说，即房颤是由多种调节因素促成并维持的。1987年至2004年期间，共有2339名入住米兰“路易吉·萨科医院”外科的患者符合本研究条件。其中1317名患者因首次诊断为结直肠癌或乳腺癌而连续入院（病例组）。其余1022名是因接受非肿瘤手术而入院的患者（对照组）。由一位不了解本研究的心脏病专家分析患者病历中常规术前心电图，以评估房颤或其他心律失常的存在情况。总体而言，病例组中房颤的发生率为3.6%，对照组为1.6%。这意味着病例组发生房颤的可能性至少是对照组的两倍。病例组和对照组中房颤的患病率均随年龄增长而增加。我们的研究描述了两种不同类型癌症中房颤患病率的增加。自主神经、内分泌、凝血和炎症改变此前在房颤和癌症中均有描述，可为我们的临床观察提供生理病理学依据。
