Eur Heart J：乳腺癌患者房颤的发生率、危险因素和死亡情况

2021-11-15 MedSci原创 MedSci原创

女性确诊乳腺癌后AF发生率明显更高。诊断时较高的乳腺癌分期与较高的AF风险显著相关。在新的乳腺癌诊断中，新发AF会增加1年心血管死亡率，但不会增加与乳腺癌相关的死亡率。

在多民族代表性的美国乳腺癌患者队列中，房颤(AF)的发病率、患病率、危险因素和死亡结局尚未明确。近日，心血管领域权威杂志Eur Heart J上发表了一篇研究文章，该研究的目的是评估乳腺癌患者AF的全国发病率、危险因素和相关死亡率。

研究人员使用监测、流行病学和最终结果与医疗保险相关的数据库，确定了2007年至2014年期间66岁以上新的主要诊断为乳腺癌的女性。这些患者分别与没有癌症的医疗保险参保人1:1匹配，每对随访1年以确定AF的主要结局。

研究人员使用竞争风险生存统计计算了累计发生率。在此之后，研究人员使用调整后的Cox比例风险模型确定乳腺癌患者AF的危险因素。最后，研究人员使用Kaplan-Meier方法和调整后的Cox比例风险模型估计新发和患有AF的乳腺癌患者的死亡率。

该研究纳入了85423名乳腺癌患者，其中9425名(11.0%)患者在乳腺癌诊断前就已诊断为AF。在乳腺癌诊断后的1年内，2993名(3.9%)患者被诊断出新发AF[发生率为3.3%，95%置信区间(CI)为3.0-3.5%；前60天（0.6%/月）的比值比更高]。相比之下，在匹配的非癌症对照者中新发AF的发生率为1.8%（95%CI为1.6-2.0%）。除了传统的人口统计学和心血管危险因素外，乳腺癌分期与AF的发展密切相关[美国癌症联合委员会(AJCC)II/III/IV期与I期：调整后的风险比(aHR)分别为1.51/2.63/4.21]。乳腺癌诊断后新发AF(aHR为3.00)与1年心血管死亡率增加有关。

由此可见，女性确诊乳腺癌后AF发生率明显更高。诊断时较高的乳腺癌分期与较高的AF风险显著相关。在新的乳腺癌诊断中，新发AF会增加1年心血管死亡率，但不会增加与乳腺癌相关的死亡率。

原始出处：

Avirup Guha.et al.Incidence, risk factors, and mortality of atrial fibrillation in breast cancer: a SEER-Medicare analysis.European Heart Journal.2021.https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab745/6427396

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2022-07-10 一叶知秋

#发生率#

39 0
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2021-11-17 一叶知秋

#ART#

35 0
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2021-11-17 slcumt

#HEART#

33 0
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2021-11-17 hanhaisha2013

#乳腺癌患者#

31 0
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2021-11-16 学医无涯

学习一下

159 0
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2021-11-15 郭静

好

155 0
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2021-11-15 ms6000000830107622

学习了赞

160 0
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2021-11-15 ms6000000656440728

是否与治疗有关咧

169 0
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2021-11-15 ms6957487107214971

学习了

156 0
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2021-11-15 yedd

房颤坚持抗凝很重要

26 0

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