Sato Takeshi, Dai Zhehao, Hashimoto Jun, Ohde Sachiko, Komiyama Nobuyuki, Inomata Takayuki, Yamauchi Teruo
Department of Cardiology, Nagaoka Chuo General Hospital, Niigata, Japan.
Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
PLoS One. 2025 Feb 25;20(2):e0319342. doi: 10.1371/journal.pone.0319342. eCollection 2025.
The association between comorbid atrial fibrillation (AF) and survival in adult patients with advanced solid cancer, as well as the impact of cardiology involvement in such patients, remains unclear.
This retrospective cohort study included adult patients diagnosed with advanced solid cancers. We calculated prevalence of AF in different cancer types and compared all-cause mortality between patients with and without AF. We further examined the association between cardiology involvement and mortality in the subset of participants with AF.
Among the 1,349 adult patients with advanced solid cancer, 122 (9.0%) had AF. The risk of AF was the highest in lung and mediastinal cancer (15.6%). AF was associated with higher all-cause mortality, which became neutral after adjustment for age, sex, comorbidities, cancer types and cancer treatments (crude hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.11-1.75, p = 0.004; adjusted HR 1.08, 95%CI 0.84-1.39, p = 0.552). In those with AF, cardiology involvement was independently associated with lower all-cause mortality (age, sex, comorbidities, cancer types and cancer treatments-adjusted HR 0.50 [95%CI 0.28-0.88], p = 0.017), though the cumulative incidence of neither cardiovascular nor non-cardiovascular death differed significantly between patients who received cardiology care and those who did not.
In adult patients with advanced solid cancer, AF per se was not independently associated with increased mortality. Cardiology involvement in patients with advanced solid cancer and AF was linked to a better overall survival, but with low certainty that this finding is not attributable to unmeasured confounding.
成年晚期实体癌患者合并心房颤动（AF）与生存之间的关联，以及心脏病学参与对此类患者的影响仍不明确。
这项回顾性队列研究纳入了诊断为晚期实体癌的成年患者。我们计算了不同癌症类型中AF的患病率，并比较了有AF和无AF患者的全因死亡率。我们进一步研究了心脏病学参与与AF参与者亚组死亡率之间的关联。
在1349例成年晚期实体癌患者中，122例（9.0%）有AF。AF风险在肺癌和纵隔癌中最高（15.6%）。AF与较高的全因死亡率相关，在调整年龄、性别、合并症、癌症类型和癌症治疗后变为中性（粗危险比[HR]1.39，95%置信区间[CI]1.11 - 1.75，p = 0.004；调整后HR 1.08，95%CI 0.84 - 1.39，p = 0.552）。在有AF的患者中，心脏病学参与与较低的全因死亡率独立相关（年龄、性别、合并症、癌症类型和癌症治疗调整后HR 0.50[95%CI 0.28 - 0.88]，p = 0.017），尽管接受心脏病学护理的患者与未接受者之间心血管死亡和非心血管死亡的累积发生率均无显著差异。
在成年晚期实体癌患者中，AF本身与死亡率增加无独立关联。心脏病学参与成年晚期实体癌合并AF患者与更好的总生存相关，但该发现并非未测量的混杂因素所致的确定性较低。
