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新发心房颤动与癌症事件的关联:一项全国性队列研究。

The association between new onset atrial fibrillation and incident cancer-A nationwide cohort study.

机构信息

Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

PLoS One. 2018 Jun 28;13(6):e0199901. doi: 10.1371/journal.pone.0199901. eCollection 2018.

Abstract

A recent analysis showed an association with new onset atrial fibrillation (NOAF) and incident cancer among women. We aimed to examine the risk of cancer among patients with NOAF in general population. A retrospective cohort of 5130 patients with NOAF was identified from a random sample of one million subjects between 2005 and 2010 from Taiwan National Health Insurance Research Database. The standard incidence ratio of incident cancer and hazard ratios were calculated by modeling cumulative incidence with competing risk of death. During a mean follow-up duration of 3.4 years, 330 patients developed cancer. The standard incidence ratio of all malignancies was 1.41 (95% confidence interval 1.26-1.57), suggesting a 41% increase in cancer risk compared with the general population. The risk of cancer was higher among men or the elderly with NOAF after adjusting for confounding factors and after considering the competing risk of death. The risk of cancer was not associated with CHA2DS2-VASc score (p = 0.32) among patients with NOAF. In conclusion, patients with NOAF were associated with a higher risk of cancer. Within this group, the risk of ischemic stroke (in terms of CHADS2-VASc score) did not reflect the risk of incident cancer.

摘要

一项近期分析显示,新发生的心房颤动(NOAF)与女性癌症发病之间存在关联。我们旨在研究一般人群中患有 NOAF 的患者发生癌症的风险。从台湾全民健康保险研究数据库中 2005 年至 2010 年期间随机抽取的 100 万例患者中,我们确定了 5130 例患有 NOAF 的患者的回顾性队列。采用竞争风险死亡模型对累积发病率进行建模,计算癌症发病的标准化发病比和风险比。在平均 3.4 年的随访期间,330 例患者发生了癌症。所有恶性肿瘤的标准化发病比为 1.41(95%置信区间 1.26-1.57),与一般人群相比,癌症风险增加了 41%。在调整混杂因素并考虑死亡的竞争风险后,NOAF 后男性或老年人的癌症风险更高。在调整了 CHA2DS2-VASc 评分(p=0.32)后,NOAF 患者的癌症风险与评分无关。总之,NOAF 患者发生癌症的风险更高。在这一组中,缺血性卒中(根据 CHADS2-VASc 评分)的风险并不能反映癌症发病的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fbe/6023210/47a21a397ee1/pone.0199901.g001.jpg

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