Key result
New-onset atrial fibrillation in cancer patients was associated with a significantly higher mortality rate compared to those who did not develop atrial fibrillation (OR 1.90).
Why the study?
To evaluate the mortality outcome of cancer patients with new-onset atrial fibrillation and assess whether surgical intervention confounded this relationship.
Does new-onset atrial fibrillation increase mortality in cancer patients without pre-existing atrial fibrillation?
Meta-Analysis
Does new-onset atrial fibrillation increase mortality in cancer patients without pre-existing atrial fibrillation?
New-onset atrial fibrillation in cancer patients is associated with a significantly higher mortality rate in both surgical and non-surgical settings, indicating a need for careful monitoring and specific management strategies.
Answers are grounded in this paper and cite their sources.
May warrant closer monitoring in cancer patients; leaves open whether targeted interventions improve survival.
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.
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Murtaza et al. (2022) conducted a meta-analysis in Cancer. New-onset atrial fibrillation vs. Cancer patients who did not develop atrial fibrillation was evaluated on Mortality (OR 1.90, 95% CI 1.65-2.19, p=<0.00001). New-onset atrial fibrillation in cancer patients was associated with a significantly higher mortality rate compared to those who did not develop atrial fibrillation (OR 1.90).
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