Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
Heart Rhythm. 2019 Mar;16(3):343-348. doi: 10.1016/j.hrthm.2018.10.017. Epub 2019 Jan 29.
Patients with breast cancer may have an increased incidence of atrial fibrillation (AF) because of the systemic inflammation induced by the cancer and side effects of treatments.
The purpose of this study was to estimate the long-term incidence of AF in patients with breast cancer compared with the background population.
We identified patients diagnosed with breast cancer from 1998 to 2015 by using nationwide registries. Female patients with breast cancer were matched (1:3) by age and sex with the background population. The long-term incidence of AF was estimated by cumulative incidence curves and multivariable Cox regression models.
We matched 74,155 patients with breast cancer with 222,465 patients from the background population. Breast cancer was associated with incident AF and the association differed between age groups (interaction analysis, P < .0001) and follow-up time periods. In patients younger than 60 years breast cancer was associated with increased incidence of AF during the first 6 months (hazard ratio [HR] 2.10; 95% confidence interval [CI] 1.25-3.44) and from 6 months to 3 years (HR 1.80; 95% CI 1.38-2.35). In patients older than 60 years, breast cancer was not associated with increased incidence of AF during the first 6 months (HR 1.13; 95% CI 0.95-1.34) and was associated with increased incidence of AF from 6 months to 3 years (HR 1.14; 95% CI 1.05-1.25).
The long-term incidence of AF was increased in patients with breast cancer and short-term incidence was increased in patients younger than 60 years and similar in patients older than 60 years compared with the background population.
由于癌症引起的全身炎症和治疗的副作用,乳腺癌患者可能会增加心房颤动(AF)的发生率。
本研究旨在估计与背景人群相比,乳腺癌患者发生 AF 的长期发生率。
我们通过全国性登记处确定了 1998 年至 2015 年期间被诊断为乳腺癌的患者。通过年龄和性别与背景人群匹配了 74155 名乳腺癌女性患者(1:3)。通过累积发病率曲线和多变量 Cox 回归模型估计 AF 的长期发生率。
我们匹配了 74155 名乳腺癌患者和 222465 名来自背景人群的患者。乳腺癌与 AF 发病有关,这种关联在年龄组(交互分析,P<0.0001)和随访时间上有所不同。在 60 岁以下的患者中,乳腺癌与前 6 个月(HR 2.10;95%置信区间 [CI] 1.25-3.44)和 6 个月至 3 年(HR 1.80;95% CI 1.38-2.35)期间 AF 发病率增加有关。在 60 岁以上的患者中,乳腺癌与前 6 个月(HR 1.13;95% CI 0.95-1.34)AF 发病率增加无关,但与 6 个月至 3 年(HR 1.14;95% CI 1.05-1.25)AF 发病率增加有关。
与背景人群相比,乳腺癌患者的 AF 长期发生率增加,60 岁以下患者的短期发生率增加,60 岁以上患者的短期发生率相似。