Key result
Breast cancer was associated with a 43% increased risk of new-onset atrial fibrillation, and atrial fibrillation was associated with an 18% increased risk of breast cancer.
Why the study?
Epidemiological studies suggest a bidirectional association between atrial fibrillation and breast cancer, prompting a meta-analysis to elucidate AF prevalence in breast cancer and clarify their bidirectional relationship.
Is there a bidirectional association between atrial fibrillation and breast cancer?
Meta-Analysis (n=8,537,551)
Is there a bidirectional association between atrial fibrillation and breast cancer?
Hazard Ratio: 1.43 (95% CI 1.12–1.82)
There is a significant bidirectional association between atrial fibrillation and breast cancer, suggesting that patients with either condition may be at elevated risk for developing the other.
Patients with breast cancer or atrial fibrillation may warrant vigilance for the other; supports bidirectional link but remains hypothesis-generating.
Background Epidemiological studies suggest a bidirectional association between atrial fibrillation and breast cancer. This study aimed to conduct a meta-analysis to elucidate the prevalence of atrial fibrillation among breast cancer patients, and the bidirectional association between atrial fibrillation and breast cancer. Methods PubMed, the Cochrane Library, and Embase were searched to identify studies reporting the prevalence, incidence, and bidirectional association between atrial fibrillation and breast cancer. The study was registered with PROSPERO (CRD42022313251). Levels of evidence and recommendations were assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Twenty-three studies (17 retrospective cohort studies, 5 case-control studies and 1 cross-sectional study) involving 8,537,551 participants were included. Among patients with breast cancer, the prevalence of atrial fibrillation was 3% (11 studies; 95% CI: 0.6 to 7.1%) and the incidence was 2.7% (6 studies; 95% CI: 1.1 to 4.9%). Breast cancer was associated with increased risk of atrial fibrillation (5 studies; hazard ratio [HR]: 1.43, 95% CI: 1.12 to 1.82, I 2 = 98%). Atrial fibrillation was also significantly associated elevated risk of breast cancer (5 studies HR: 1.18, 95% CI: 1.14 to 1.22, I 2 = 0%). Grade assessment shown low certainty of the evidence for the risk of atrial fibrillation and moderate certainty of the evidence for the risk of breast cancer. Conclusion Atrial fibrillation is not uncommon in patients with breast cancer and vice versa. There is a bidirectional association between atrial fibrillation (low certainty) and breast cancer (moderate certainty).
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Yao et al. (2023) conducted a meta-analysis in Breast cancer and Atrial fibrillation (n=8,537,551). Breast cancer vs. Patients without breast cancer was evaluated on Risk of new-onset atrial fibrillation (HR 1.43, 95% CI 1.12 to 1.82). Breast cancer was associated with a 43% increased risk of new-onset atrial fibrillation, and atrial fibrillation was associated with an 18% increased risk of breast cancer.
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