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癌症会增加长期随访期间发生心房颤动的风险(OPERA 研究)。

Cancer increases the risk of atrial fibrillation during long-term follow-up (OPERA study).

机构信息

Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.

出版信息

PLoS One. 2018 Oct 5;13(10):e0205454. doi: 10.1371/journal.pone.0205454. eCollection 2018.

Abstract

INTRODUCTION

Relation between atrial fibrillation (AF) and cancer is known but not very well understood. The purpose of this prospective study was to find out whether subjects with cancer were at greater risk of AF than subjects without cancer.

MATERIALS AND METHODS

The study was based on the OPERA (Oulu Project Elucidating Risk of Atherosclerosis) material and had 1045 subjects and the mean follow-up time of 16.3 years. During the follow-up AF and cancer diagnosis were made (atrial flutter included) if these events were listed in the National Death Registry and/or hospital discharge registry.

RESULTS

In this study 130 subjects (12%) had cancer and 19% of these had AF, whereas only 9% of those without cancer experienced AF during the follow-up (p<0.001). Subjects in the cancer group had greater probability of developing atrial fibrillation during the follow-up time in comparison to the subjects without cancer (Hazard ratio (HR) 2.47 (95%CI) 1.57-3.88) in multivariate model including relevant confounding factors.

CONCLUSION

The main finding of this OPERA study was that cancer is an independent risk factor of atrial fibrillation. Still it remains unclear whether this association is causative or whether cancer and atrial fibrillation just share the same pathophysiologic mechanisms.

摘要

简介

心房颤动(AF)与癌症之间的关系是已知的,但尚未得到很好的理解。本前瞻性研究的目的是确定患有癌症的患者是否比没有癌症的患者发生 AF 的风险更高。

材料与方法

本研究基于 OPERA(奥卢动脉粥样硬化风险研究)的资料,共纳入 1045 名患者,平均随访时间为 16.3 年。在随访期间,如果国家死亡登记处和/或住院记录中列出了 AF 和癌症诊断(包括心房扑动),则进行这些诊断。

结果

在这项研究中,130 名患者(12%)患有癌症,其中 19%患有 AF,而在没有癌症的患者中,只有 9%在随访期间发生了 AF(p<0.001)。在多变量模型中包括相关混杂因素后,癌症组患者在随访期间发生心房颤动的可能性明显高于无癌症组患者(风险比(HR)2.47(95%CI)1.57-3.88)。

结论

本 OPERA 研究的主要发现是癌症是心房颤动的独立危险因素。但尚不清楚这种关联是因果关系,还是癌症和心房颤动只是具有相同的病理生理机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64bd/6173458/83118ba4b299/pone.0205454.g001.jpg

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