Risk of Atrial Fibrillation According to Cancer Type
Jun Pil Yun, Eue‐Keun Choi, Kyungdo Han, Sang Hyun Park, Jin‐Hyung Jung, Sang Hyeon Park, Hyo‐Jeong Ahn, Jaehyun Lim, So‐Ryoung Lee, Seil Oh
Abstract
BACKGROUND: Patients with cancer have an increased risk of atrial fibrillation (AF). However, there is a paucity of information regarding the association between cancer type and risk of AF. OBJECTIVES: This study sought to evaluate the risk of AF according to the type of cancer. METHODS: We enrolled 816,811 patients who were diagnosed with cancer from the Korean National Health Insurance Service database between 2009 and 2016. Age- and sex-matched noncancer control subjects (1:2; n = 1,633,663) were also selected. Newly diagnosed AF was identified based on the type of cancer. RESULTS: During a median follow-up of 4.5 years, AF was newly diagnosed in 25,356 patients with cancer (6.6 per 1,000 person-years). In multivariable Fine and Gray's regression analysis, cancer was an independent risk factor for incident AF (adjusted subdistribution hazard ratio [aHR]: 1.63; 95% confidence interval [CI]: 1.61 to 1.66). Multiple myeloma showed a higher association with incident AF (aHR: 3.34; 95% CI: 2.98 to 3.75). Esophageal cancer showed the highest risk among solid cancers (aHR: 2.69; 95% CI: 2.45 to 2.95), and stomach cancer showed the lowest association with AF risk (aHR: 1.27; 95% CI 1.23 to 1.32). CONCLUSIONS: Although patients with cancer were found to have a higher risk of AF, the impact on AF development varied by cancer type.