Study Finds Cancer Increases Risk of AFib, But Varies Depending on Type of Cancer

Patients with cancer may be at higher risk for atrial fibrillation (AFib), although the impact on AFib development varies by cancer type, according to a study published June 15 in JACC: CardioOncology. Researchers suggest an increased risk of AFib should be considered when treating patients with cancer.

In the nationwide population-based study out of South Korea, Jun Pil Yun, MD, et al., observed 816,811 patients who were diagnosed with cancer in the Korean National Health Insurance Service database from 1994-2014. Newly diagnosed AFib was identified based on the type of cancer; there were 19 types of cancer analyzed separately.

During a median follow-up of 4.5 years, AFib was newly diagnosed in 25,356 patients with cancer. All types of cancer contributed to the incidence of AFib, but the rate varied according to the cancer type. Patients with multiple myeloma showed the highest risk of AFib, and those with stomach cancer had the lowest risk of AFib. Among solid cancers, esophageal cancer had the highest risk of AFib development.

Since patients with certain types of cancer had a higher risk of AFib, the paper suggests physicians may consider more intensive screening in these patient subgroups. Yet, the authors conclude that it is unclear whether routine screening can improve outcomes and additional study is needed.

In a related editorial comment, Konstantinos C. Siontis, MD, FACC, et al., explain, "The coexistence of cancer and AFib will be an increasing problem owing to the aging population and improved survival of cancer patients thanks to ever-improving antineoplastic strategies. This and other studies highlight the complex link between cancer and AFib. The need to fill the gaps in evidence surrounding AFib pathogenesis and optimal screening and management is becoming increasingly pressing."

Online Course: Managing AFib and BTK Inhibitors: Balancing Risk

The ACC has created the Managing AFib and BTK Inhibitors: Balancing Risk online course to educate the medical community about the importance of assessing risk, monitoring, and managing AFib and other cardiovascular risk factors for oncology patients. Review important topics such as patient-specific risk factors, antiplatelet activity of Bruton's Tyrosine Kinase (BTK) inhibitors and drug-drug interactions, as well as the steps to anticoagulation and dosing requirements in different chronic lymphocytic leukemia/lymphoma patients. Learn more.

Clinical Topics: Arrhythmias and Clinical EP, Cardio-Oncology, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: ACC International, Cardiotoxicity, Atrial Fibrillation, Stomach Neoplasms, Multiple Myeloma, Antineoplastic Agents, Phytogenic, Esophageal Neoplasms

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