Atrial fibrillation and cancer: prevalence and relative risk from a nationwide study

Cihan Ay; Ella Grilz; Stephan Nopp; Florian Moik; Oliver Königsbrügge; Peter Klimek; Stefan Thurner; Florian Posch; Ingrid Pabinger

doi:10.1016/j.rpth.2022.100026

Atrial fibrillation and cancer: prevalence and relative risk from a nationwide study

Res Pract Thromb Haemost. 2022 Dec 23;7(1):100026. doi: 10.1016/j.rpth.2022.100026. eCollection 2023 Jan.

Authors

Cihan Ay¹, Ella Grilz¹, Stephan Nopp¹, Florian Moik^{1

2}, Oliver Königsbrügge¹, Peter Klimek^{3

4}, Stefan Thurner^{3

4

5}, Florian Posch², Ingrid Pabinger¹

Affiliations

¹ Department of Medicine I, Medical University of Vienna, Vienna, Austria.
² Department of Internal Medicine, Medical University of Graz, Graz, Austria.
³ Section for Science of Complex Systems, CEMSIIS, Medical University of Vienna, Vienna, Austria.
⁴ Complexity Science Hub Vienna, Vienna, Austria.
⁵ Santa Fe Institute, Santa Fe, New Mexico, USA.

Abstract

Background: Atrial fibrillation (AF) is an increasingly recognized codiagnosis in patients with cancer.

Objectives: This study aimed to provide a robust and contemporary estimate on the coprevalence and relative risk of AF in patients with cancer.

Methods: We conducted a nationwide analysis, utilizing diagnosis codes from the Austrian Association of Social Security Providers dataset. Estimates of the coprevalence of cancer and AF and the relative risk of AF in patients with cancer compared with individuals without cancer were obtained as point prevalences with binomial exact confidence intervals and summarized across age groups and cancer types with random-effects models.

Results: Overall, 8,306,244 persons were included in the present analysis, of whom 158,675 (prevalence estimate, 1.91%; 95% CI, 1.90-1.92) had a cancer diagnosis code and 112,827 (1.36%; 95% CI, 1.35-1.36) an AF diagnosis code, respectively. The prevalence estimate for AF in patients with cancer was 9.77% (95% CI, 9.63-9.92) and 1.19% (95% CI, 1.19-1.20) in the noncancer population. Conversely, 13.74% (95% CI, 13.54-13.94) of patients with AF had a concurrent cancer diagnosis. The corresponding age-stratified random-effects relative risk ratio for AF in patients with cancer compared with no cancer diagnosis was 10.45 (95% CI, 7.47-14.62). The strongest associations between cancer and AF were observed in younger persons and patients with hematologic malignancies.

Conclusion: Cancer and AF have a substantial coprevalence in the population. This finding corroborates the concept that cancer and AF have common risk factors and pathophysiology.

Keywords: atrial fibrillation; cancer; nationwide study; neoplasms; prevalence.