Oh Mi Jin, Choi Yoon Jin, Jung Jin-Hyung, Lee Seunghan, Han Kyungdo, Cho Soo-Jeong
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea.
Cancers (Basel). 2025 Jun 19;17(12):2054. doi: 10.3390/cancers17122054.
BACKGROUND/OBJECTIVES: Patients with gastric cancer (GC) have an elevated risk of atrial fibrillation (AF) and cardiovascular mortality, compared with the general population. However, the effect of the cancer stage on the development of AF remains unclear. This study aimed to evaluate the relationship between the risk of AF and GC stage based on the Surveillance, Epidemiology, and End Results (SEER) stage classifications.
This retrospective population-based cohort study enrolled patients diagnosed with GC between 2012 and 2019, using anonymized data from the Cancer Public Library Database of South Korea. Patients were followed up until 2020. The risk of AF was assessed in relation to the SEER stage of GC (localized, regional, distant) using adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Subgroup analyses were performed according to age, sex, year of diagnosis, and comorbidities.
Of the 211,500 patients enrolled in this study, 7266 were diagnosed with AF during follow-up. The risk of AF increased progressively with cancer stage, with aHRs of 2.00 (95% CI 1.81-2.22) for the distant stage and 1.32 (95% 1.25-1.41) for the regional stage, compared with the localized stage. Subgroup analyses showed a consistent association between advanced cancer stage and a higher AF risk; the association was stronger in the younger, female, and non-hypertensive subgroups.
The risk of AF in patients with GC is associated with the initial stage, highlighting the need for the closer monitoring and management of AF to improve the survival of patients with advanced-stage GC.
背景/目的：与普通人群相比，胃癌（GC）患者发生心房颤动（AF）和心血管疾病死亡的风险更高。然而，癌症分期对AF发生的影响仍不明确。本研究旨在基于监测、流行病学和最终结果（SEER）分期分类评估AF风险与GC分期之间的关系。
这项基于人群的回顾性队列研究纳入了2012年至2019年间诊断为GC的患者，使用了韩国癌症公共图书馆数据库的匿名数据。对患者进行随访至2020年。使用调整后的风险比（aHRs）及95%置信区间（CIs）评估与GC的SEER分期（局限性、区域性、远处性）相关的AF风险。根据年龄、性别、诊断年份和合并症进行亚组分析。
在本研究纳入的211,500例患者中，7266例在随访期间被诊断为AF。与局限性分期相比，AF风险随着癌症分期的进展而逐渐增加，远处分期的aHR为2.00（95%CI 1.81 - 2.22），区域性分期的aHR为1.32（95% 1.25 - 1.41）。亚组分析显示癌症晚期与较高的AF风险之间存在一致的关联；在年轻、女性和非高血压亚组中这种关联更强。
GC患者的AF风险与初始分期相关，这突出了对AF进行更密切监测和管理以提高晚期GC患者生存率的必要性。
