Prevalence, incidence and impact of cancer in atrial fibrillation: a systematic review and meta-analysis of 6,600,000 patients

Abstract

Aims Contemporary studies have indicated that atrial fibrillation (AF) is common among cancer patients, and affects the prognosis of cancer patients. The other hand, AF and cancer share the same risk factors, while the prevalence, incidence and impact of cancer in AF patients is unclear. Our aim was to estimate the prevalence and incidence of cancer, and focus on the impact of cancer on clinical outcome. Methods and Results We searched the PubMed, Web of science, Embase and Cochrane Library databases, and conducted according to international guidelines to perform a system review and meta-analysis. All studies reporting the prevalence and incidence of cancer were included. We extracted the data from these studies and used the random effect model to pool the result. The prevalence and incidence of cancer overall were 1153.31 (95%CI: 959.19-1380.72) per 10000 patients, 173.28 (95%CI: 131.89-227.66) per 10000 person-years, respectively. Otherwise, cancer prevalence and incidence had been shown to vary by cancer type, the incidence also varies gender and comorbidities. And cancer is associated with higher risk of all-death (OR: 1.78, 95%CI: 1.51–2.08) and bleeding (OR: 1.44, 95%CI: 1.26–1.65), no significant differences in cardiovascular death and stroke/system embolism. Conclusions Cancer is common in AF patients, affecting 11% of patients. The incidence of cancer cannot be ignored. Cancer is associated with the worse outcome in AF patients, with more than 1.7-flod higher risk of all-death and increased the risk of bleeding.