Atrial fibrillation in cancer survivors – a systematic review and meta-analysis

Abstract Background Atrial fibrillation (AF) is a common cardiac complication during cancer treatment. It is unclear if cancer survivors have increased AF risk when compared to the population. AF screening is now recommended in patients ≥65 years, however there are no specific recommendations in the...

Full description

Bibliographic Details
Main Authors: Yueyang Bao, John Lee, Udit Thakur, Satish Ramkumar, Thomas H. Marwick
Format: Article
Language:English
Published: BMC 2023-06-01
Series:Cardio-Oncology
Subjects:
Online Access:https://doi.org/10.1186/s40959-023-00180-3
_version_ 1797801278681645056
author Yueyang Bao
John Lee
Udit Thakur
Satish Ramkumar
Thomas H. Marwick
author_facet Yueyang Bao
John Lee
Udit Thakur
Satish Ramkumar
Thomas H. Marwick
author_sort Yueyang Bao
collection DOAJ
description Abstract Background Atrial fibrillation (AF) is a common cardiac complication during cancer treatment. It is unclear if cancer survivors have increased AF risk when compared to the population. AF screening is now recommended in patients ≥65 years, however there are no specific recommendations in the oncology population. We sought to compare the AF detection rate of cancer survivors compared to the general population. Methods We searched the Pubmed, Embase and Web of Science databases using search terms related to AF and cancer mapped to subject headings. We included English language studies, limited to adults > 18 years who were > 12 months post completion of cancer treatment. Using a random-effects model we calculated the overall AF detection rate. Meta-regression analysis was performed to assess for potential causes for study heterogeneity. Results Sixteen studies were included in the study. The combined AF detection rate amongst all the studies was 4.7% (95% C.I 4.0-5.4%), which equated to a combined annualised AF rate of 0.7% (95% C.I 0.1–0.98%). There was significant heterogeneity between studies (I 2  = 99.8%, p < 0.001). In the breast cancer cohort (n = 6 studies), the combined annualised AF rate was 0.9% (95% C.I 0.1–2.3%), with significant heterogeneity (I 2  = 99.9%, p < 0.001). Conclusion Whilst the results should be interpreted with caution due to study heterogeneity, AF rates in patients with cancer survival >12 months were not significantly increased compared to the general population. Study Registration Open Science Framework - DOI: https://doi.org/10.17605/OSF.IO/APSYG .
first_indexed 2024-03-13T04:48:02Z
format Article
id doaj.art-f63d1d65ba20402b8cd21020a033d406
institution Directory Open Access Journal
issn 2057-3804
language English
last_indexed 2024-03-13T04:48:02Z
publishDate 2023-06-01
publisher BMC
record_format Article
series Cardio-Oncology
spelling doaj.art-f63d1d65ba20402b8cd21020a033d4062023-06-18T11:26:09ZengBMCCardio-Oncology2057-38042023-06-019111010.1186/s40959-023-00180-3Atrial fibrillation in cancer survivors – a systematic review and meta-analysisYueyang Bao0John Lee1Udit Thakur2Satish Ramkumar3Thomas H. Marwick4School of Medicine, University of TasmaniaDepartment of Cardiology, Royal Hobart HospitalMonash Cardiovascular Research Centre and MonashHeart, Monash HealthMonash Cardiovascular Research Centre and MonashHeart, Monash HealthBaker Heart and Diabetes InstituteAbstract Background Atrial fibrillation (AF) is a common cardiac complication during cancer treatment. It is unclear if cancer survivors have increased AF risk when compared to the population. AF screening is now recommended in patients ≥65 years, however there are no specific recommendations in the oncology population. We sought to compare the AF detection rate of cancer survivors compared to the general population. Methods We searched the Pubmed, Embase and Web of Science databases using search terms related to AF and cancer mapped to subject headings. We included English language studies, limited to adults > 18 years who were > 12 months post completion of cancer treatment. Using a random-effects model we calculated the overall AF detection rate. Meta-regression analysis was performed to assess for potential causes for study heterogeneity. Results Sixteen studies were included in the study. The combined AF detection rate amongst all the studies was 4.7% (95% C.I 4.0-5.4%), which equated to a combined annualised AF rate of 0.7% (95% C.I 0.1–0.98%). There was significant heterogeneity between studies (I 2  = 99.8%, p < 0.001). In the breast cancer cohort (n = 6 studies), the combined annualised AF rate was 0.9% (95% C.I 0.1–2.3%), with significant heterogeneity (I 2  = 99.9%, p < 0.001). Conclusion Whilst the results should be interpreted with caution due to study heterogeneity, AF rates in patients with cancer survival >12 months were not significantly increased compared to the general population. Study Registration Open Science Framework - DOI: https://doi.org/10.17605/OSF.IO/APSYG .https://doi.org/10.1186/s40959-023-00180-3Atrial fibrillationScreeningSurvivorship
spellingShingle Yueyang Bao
John Lee
Udit Thakur
Satish Ramkumar
Thomas H. Marwick
Atrial fibrillation in cancer survivors – a systematic review and meta-analysis
Cardio-Oncology
Atrial fibrillation
Screening
Survivorship
title Atrial fibrillation in cancer survivors – a systematic review and meta-analysis
title_full Atrial fibrillation in cancer survivors – a systematic review and meta-analysis
title_fullStr Atrial fibrillation in cancer survivors – a systematic review and meta-analysis
title_full_unstemmed Atrial fibrillation in cancer survivors – a systematic review and meta-analysis
title_short Atrial fibrillation in cancer survivors – a systematic review and meta-analysis
title_sort atrial fibrillation in cancer survivors a systematic review and meta analysis
topic Atrial fibrillation
Screening
Survivorship
url https://doi.org/10.1186/s40959-023-00180-3
work_keys_str_mv AT yueyangbao atrialfibrillationincancersurvivorsasystematicreviewandmetaanalysis
AT johnlee atrialfibrillationincancersurvivorsasystematicreviewandmetaanalysis
AT uditthakur atrialfibrillationincancersurvivorsasystematicreviewandmetaanalysis
AT satishramkumar atrialfibrillationincancersurvivorsasystematicreviewandmetaanalysis
AT thomashmarwick atrialfibrillationincancersurvivorsasystematicreviewandmetaanalysis