First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

Abstract

Aim of the present study was to assess the prevalence of atrial fibrillation (AF) in patients with two different types of cancer. Recent epidemiologic and clinical studies support the hypothesis that AF is promoted and maintained by a broad spectrum of modulating factors. A total of 2,339 patients admitted to the Surgery Department of "Luigi Sacco Hospital, Milan," over the period 1987-2004 were eligible for the study. One thousand three hundred and seventeen patients were admitted consecutively with a first diagnosis of colorectal or breast cancer (cases). The remaining 1,022 were patients admitted to undergo non-neoplastic surgery (controls). Routine pre-surgery electrocardiogram available in patient charts was analysed by a cardiologist who was not aware of the present study to evaluate the presence of atrial fibrillation or other arrhythmias. Overall, AF was present in 3.6% cases and 1.6% controls. This corresponded to at least two times higher likelihood of having AF in cases compared to controls. Prevalence of AF increased with age both in cases and controls. Our study describes an increased prevalence of AF in two different types of cancer. Autonomic, endocrine, coagulation, and inflammatory alterations were previously described in both AF and cancer, and can provide the physiopathological basis to our clinical observation.

Zoledronic acid and atrial fibrillation in cancer patients

“…Few data exist upon AF and malignant diseases. In the study of Guzzetti, colon and breast cancer patients had threefold higher AF frequency compared to non-malignant patients [15]. Atrial fibrillation risk was known to increase with excess inflammation [16].…”

Cardiovascular Complications of Cancer Therapy

“…Another study examined 28,333 patients with AF compared with 282,260 patients without AF found the prevalence of colorectal cancer to be 0.59% in patients with AF, and only 0.05% in those without AF (129). Another study found postop AF to be more common after breast and colorectal cancer surgery (3.6%) compared with non-cancer surgery (1.6%) (130). Thus, cancer is associated with higher risk of AF.…”

Pathophysiology of cancer therapy-provoked atrial fibrillation

“…AF was more prevalent in participants with a history of non-life-threatening cancer and those who did not need active cancer therapies [66]. Case-control studies in breast cancer and colon cancer support the claim that cancer affects AF development [13,29,[115][116][117]. Potentially, alterations in inflammation are common in both malignancy and AF [40,117,118].…”

“…AF after an esophagectomy was suggested to be a marker for postoperative morbidity and mortality [28]. In a case-control study, the prevalence of AF was 2-times higher among patients admitted for colorectal or breast cancer surgery compared to patients undergoing non-cancer-related surgery [29]. Thus, we need to understand the mechanisms of POAF formation in cancer patients.…”

“…Previous studies suggested that cancer itself is a comorbid factor that predisposes one to AF in patients with non-life threatening cancer [13,29,[115][116][117]. AF was more prevalent in participants with a history of non-life-threatening cancer and those who did not need active cancer therapies [66].…”