January 29, 2019
2 min read

Breast cancer increases long-term incidence of AF

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Women with breast cancer had an increased incidence of atrial fibrillation, according to a study published in HeartRhythm.

The short-term incidence of AF increased in women younger than 60 years and was similar in women older than 60 years, according to the study.

“Modern treatment regimens ensure that approximately 80% of breast cancer patients become long-term survivors,” Maria D’Souza, MD, of the department of cardiology at Copenhagen University Hospital Herlev-Gentofte in Hellerup, Denmark, said in a press release. “Healthy survivorship can be threatened, however, by long-term complications resulting from both the cancer and related treatments. Notably, increased frequencies of cardiovascular disease, especially heart failure and ischemic heart disease, have been observed in survivors. We hypothesized that women with breast cancer could also be more prone to developing AF because breast cancer induces inflammation.”

Researchers analyzed data from 74,155 women (mean age, 62 years) from several Danish registries who had breast cancer from 1998 to November 2015. These women were matched by sex and age to 222,465 women from the Danish background population.

The outcome of interest was hospitalization with a discharge diagnosis of AF.

Multivariable Cox regression models found that breast cancer was linked to incident AF. This association was different between follow-up time periods and age groups (P for interaction < .0001).

Women younger than 60 years with breast cancer had an increased incidence of AF during the first 6 months (HR = 2.1; 95% CI, 1.25-3.44) and from 6 months to 3 years (HR = 1.8; 95% CI, 1.37-2.35).

Incidence of AF did not increase during the first 6 months in women older than 60 years (HR = 1.13; 95% CI, 0.95-1.34), although it did increase from 6 months to 3 years (HR = 1.14; 95% CI, 1.05-1.25).

“Our findings warrant future research on the associations of exposures such as systemic inflammation caused by the disease as well as the conventional treatments — radiotherapy, anthracycline, trastuzumab (Herceptin, Genentech) and aromatase inhibitors — with the development of AF,” D’Souza and colleagues wrote.

“Work of D’Souza et al is a contribution to the burgeoning field of cardio-oncology and provides support for further research into the potentially bidirectional relationship between cancer and AF,” Ankur A. Karnik, MD, FHRS, FACC, attending physician and clinical assistant professor of medicine at Boston University School of Medicine, and colleagues wrote in a related editorial. – by Darlene Dobkowski

Disclosures: The study was funded by the Danish Heart Foundation and the VELUX Foundations. D’Souza reports he received grants from the Danish Heart Foundation and the VELUX Foundations. Karnik reports no relevant financial disclosures. Please see the study and editorial for all other authors’ relevant financial disclosures.