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Review
. 2019 Apr 14:2019:8985273.
doi: 10.1155/2019/8985273. eCollection 2019.

Association of Cancer and the Risk of Developing Atrial Fibrillation: A Systematic Review and Meta-Analysis

Ming Yuan  1 , Zhiwei Zhang  1 , Gary Tse  2   3 , Xiaojin Feng  1 , Panagiotis Korantzopoulos  4 , Konstantinos P Letsas  5 , Bryan P Yan  2   6 , William K K Wu  7 , Huilai Zhang  8 , Guangping Li  1 , Tong Liu  1 , Yunlong Xia  9
Affiliations
Review

Association of Cancer and the Risk of Developing Atrial Fibrillation: A Systematic Review and Meta-Analysis

Ming Yuan et al. Cardiol Res Pract. .

Abstract

Aims: Previous studies have demonstrated epidemiological evidence for an association between cancer and the development of new-onset atrial fibrillation (AF). However, these results have been conflicting. This systematic review and meta-analysis was conducted to examine the relationship between cancer and the risk of developing atrial fibrillation.

Methods: PubMed and Web of Science were searched for publications examining the association between cancer and atrial fibrillation risk published until June 2017. Adjusted odds ratios (ORs) or hazard ratios (HRs) and 95% CI were extracted and pooled.

Results: A total of five studies involving 5,889,234 subjects were included in this meta-analysis. Solid cancer patients are at higher risk developing atrial fibrillation compared to noncancer patients (OR 1.47, 95% CI 1.31 to 1.66, p < 0.00001; I 2 = 67%, p=0.02). The risk of atrial fibrillation was highest within 90 days of cancer diagnosis (OR 7.62, 95% CI 3.08 to 18.88, p < 0.00001) and this risk diminished with time.

Conclusions: The risk of AF was highest within 90 days of cancer diagnosis. We should take into account the increased risk of atrial fibrillation development and, after this, study the embolic risk and potential indication of oral anticoagulation.

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Figures

Figure 1
Figure 1
Flow diagram of the study selection process. AF = atrial fibrillation; OR = odds ratio.
Figure 2
Figure 2
Forest plot for pooled odds ratio (OR) for the risk of atrial fibrillation (AF) in patients with any cancer. SE = standard error; IV = inverse variance.
Figure 3
Figure 3
Outcomes for the risk of atrial fibrillation (AF) in patients with different cancer. (a) Forest plot of the odds ratio (OR) for pooled risk of atrial fibrillation (AF) in patients with colorectal cancer; (b) forest plot of the odds ratio (OR) for pooled risk of atrial fibrillation in patients with breast cancer. SE = standard error; IV = inverse variance.
Figure 4
Figure 4
Funnel plot for the association between cancer and atrial fibrillation occurrence. SE = standard error; OR = odds ratio.
See this image and copyright information in PMC

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