한빛사논문
- 조회444
Yong‑Moon Mark Park1,2†, Wonyoung Jung3,4†, Yohwan Yeo5, Sang Hyun Park6, Michael G. Fradley7, Sindhu J. Malapati2,8, Tushar Tarun9, Vinay Raj10, Hong Seok Lee11, Tasneem Z. Naqvi12, Ronda S. Henry‑Tillman2,13, Jawahar L. Mehta9, Mario Schootman2,14, Benjamin C. Amick III1,2, Kyungdo Han15* and Dong Wook Shin16,17*
1Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
2Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
3Department of Family Medicine / Obesity and Metabolic Health Center, College of Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.
4Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
5Department of Family Medicine, College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
6Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
7Cardio‑Oncology Program, Division of Cardiology, Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA.
8Division of Medical Oncology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
9Division of Cardiology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
10Department of Biology & Department of Math and Computer Science, University of Arkansas at Pine Bluf, Pine Bluf, AR, USA.
11Division of Cardiology, Sarver Heart Center, Banner University Medical Group, University of Arizona, Tucson, AZ, USA.
12Division of Echocardiography, Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA.
13Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
14Department of Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
15Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo‑Ro, Dongjak‑Gu, Seoul 06978, Republic of Korea.
16Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon‑Ro, Gangnam‑Gu, Seoul 06351, Republic of Korea.
17Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Republic of Korea
†Yong-Moon Mark Park and Wonyoung Jung contributed equally to this work.
*Correspondence: Kyungdo Han, Dong Wook Shin
Abstract
Background: The risk of incident atrial fibrillation (AF) among breast cancer survivors, especially for younger women, and cancer treatment effects on the association remain unclear. This study aimed to investigate the risk of AF among breast cancer survivors and evaluate the association by age group, length of follow-up, and cancer treatment.
Methods: Using data from the Korean Health Insurance Service database (2010-2017), 113,232 women newly diagnosed with breast cancer (aged ≥ 18 years) without prior AF history who underwent breast cancer surgery were individually matched 1:5 by birth year to a sample female population without cancer (n = 566,160) (mean[SD] follow-up, 5.1[2.1] years). Sub-distribution hazard ratios (sHRs) and 95% confidence intervals (CIs) considering death as a competing risk were estimated, adjusting for sociodemographic factors and cardiovascular/non-cardiovascular comorbidities.
Results: BCS had a slightly increased AF risk compared to their cancer-free counterparts (sHR 1.06; 95% CI 1.00-1.13), but the association disappeared over time. Younger BCS (age < 40 years) had more than a 2-fold increase in AF risk (sHR 2.79; 95% CI 1.98-3.94), with the association remaining similar over 5 years of follow-up. The increased risk was not observed among older BCS, especially those aged > 65 years. Use of anthracyclines was associated with increased AF risk among BCS (sHR 1.57; 95% CI 1.28-1.92), which was more robust in younger BCS (sHR 1.94; 95% CI 1.40-2.69 in those aged ≤ 50 years).
Conclusions: Our findings suggest that younger BCS had an elevated risk of incident AF, regardless of the length of follow-up. Use of anthracyclines may be associated with increased mid-to-long-term AF risk among BCS.
논문정보
- Research article
- 2024년 02월 (BRIC 등록일 2024-02-29)
- 국내(교신)+국외 연구진
- 의약학 > 종양의학
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