Higher Mortality Associated With New-Onset Atrial Fibrillation in Cancer Patients: A Systematic Review and Meta-Analysis

Minha Murtaza; Mirza Mehmood Ali Baig; Jawad Ahmed; Liviu Ionut Serbanoiu; Stefan Sebastian Busnatu

doi:10.3389/fcvm.2022.867002

Higher Mortality Associated With New-Onset Atrial Fibrillation in Cancer Patients: A Systematic Review and Meta-Analysis

Front Cardiovasc Med. 2022 Apr 14:9:867002. doi: 10.3389/fcvm.2022.867002. eCollection 2022.

Authors

Minha Murtaza¹, Mirza Mehmood Ali Baig¹, Jawad Ahmed¹, Liviu Ionut Serbanoiu², Stefan Sebastian Busnatu²

Affiliations

¹ Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.
² Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Abstract

Aim: This research was conducted to evaluate the mortality outcome of cancer patients with new-onset atrial fibrillation. We also aimed to assess if there was any confounding relation between the mortality of these patients and surgical intervention.

Materials and methods: A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 7 February 2022. All statistical analyses were conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. Only those studies that involved cancer patients without pre-existing atrial fibrillation were selected, and mortality rate was compared between the patients who developed atrial fibrillation and those who did not. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the odds ratio (OR) and the corresponding 95% confidence interval (CI).

Results: Eighteen studies were selected for meta-analysis. Statistical analysis showed that the cancer patients who subsequently developed atrial fibrillation had a significantly higher mortality rate as compared to those who did not (OR = 1.90 [1.65, 2.19]; p < 0.00001; I ² = 100%). We also separately analyzed the mortality risk in the surgery group and the non-surgery group. Statistical analysis showed that there was significantly higher mortality rate associated with new-onset atrial fibrillation in cancer patients in the surgery group (OR= 3.68 [2.29, 5.94]; p < 0.00001; I ² = 61%) as well as in the non-surgery group (OR = 1.64 [1.39, 1.93]; p < 0.00001; I ² = 100%).

Conclusion: Cancer patients, who subsequently developed atrial fibrillation, had a higher mortality rate as compared to those cancer patients who did not develop atrial fibrillation. A higher mortality rate was seen in both surgical and non-surgical subgroups. This implies that extra care and specific measures must be taken in the management of cancer patients with new-onset atrial fibrillation.

Keywords: cancer; cardio-oncology; meta-analysis; mortality; new-onset atrial fibrillation.

Publication types

Systematic Review