Arrhythmias & electrophysiologyCohort study
Coexisting atrial fibrillation and cancer: time trends and associations with mortality in a nationwide Dutch study
- Nationwide matched cohort study
- matched control cohorts
- time-dependent Cox regression
Authors' conclusion
Atrial fibrillation and cancer were associated bidirectionally and were increasingly coexisting, but AF risk varied by cancer type. Coexisting AF and cancer were negatively associated with survival.
Study context
- Population
- Dutch nationwide population with incident atrial fibrillation (AF) or cancer, 2015–19matched cohorts
- Participants
- 320,139 / 320,135 / 472,745 / 472,741
- Exposure
- Incident AF vs matched controls; incident cancer vs matched controls
- AFn = 320,139
- AF controlsn = 320,135reference
- Cancern = 472,745
- Cancer controlsn = 472,741reference
- Outcome
- Prevalence of cancer/AF at baseline, 1-year risk of cancer/AF diagnosis and time trends; association with all-cause mortality
- Follow-up
- 1 year
Main finding
As reported in the abstract
Prevalence and 1-year risk of cancer (AF cohort) and of AF (cancer cohort)
AF
12.6%
Cancer prevalence · 1-year cancer risk 2.5%
AF controls
5.6%
Cancer prevalence · 1-year cancer risk 1.8%
Cancer
7.5%
AF prevalence · 1-year AF risk 2.8%
Cancer controls
4.3%
AF prevalence · 1-year AF risk 1.2%
Adjusted hazard ratio (95% CI)
AF vs AF controls1-year cancer risk; similar by cancer type
1.52(1.46–1.58)
Cancer vs Cancer controls1-year AF risk; higher for oesophagus, lung, stomach, myeloma, lymphoma
2.78(2.69–2.87)
- Cancer prevalence in AF cohort increasing
- 11.9% to 13.2%
- AF prevalence in cancer cohort increasing
- 6.9% to 8.2%
Observational data: associations, not effects.
Further findings
All-cause mortality
| Comparison | aHR (95% CI) | |
|---|---|---|
| Cancer after incident AF · strength of association varied by cancer type · time-dependent Cox regression | 7.77 (7.45–8.11) | |
| AF after incident cancer · strength of association varied by cancer type · time-dependent Cox regression | 2.55 (2.47–2.63) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Original publication
Coexisting atrial fibrillation and cancer: time trends and associations with mortality in a nationwide Dutch study. Eur Heart J. Published 15 April 2024. doi:10.1093/eurheartj/ehae222
Summarised from the published abstract; every number is checked against it