title: Relation between cancer and atrial fibrillation (from the REasons for Geographic And Racial Differences in Stroke Study).
abstract: Atrial fibrillation (AF) is common in patients with life-threatening cancer and those undergoing active cancer treatment. However, data from subjects with a history of non-life-threatening cancer and those who do not require active cancer treatment are lacking. A total of 15,428 (mean age 66 ± 8.9 years; 47% women; 45% blacks) participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study with baseline data on previous cancer diagnosis and AF were included. Participants with life-threatening cancer and active cancer treatment within 2 years of study enrollment were excluded. History of cancer was identified using computer-assisted telephone interviews. AF cases were identified from baseline electrocardiogram data and by a self-reported history of a previous diagnosis. Logistic regression was used to examine the cross-sectional association between cancer diagnosis and AF. A total of 2,248 (15%) participants had a diagnosis of cancer and 1,295 (8.4%) had AF. In a multivariable logistic regression model adjusted for sociodemographic characteristics (age, gender, race, education, income, and region of residence) and cardiovascular risk factors (systolic blood pressure, high-density lipoprotein cholesterol, total cholesterol, C-reactive protein, body mass index, smoking, diabetes, antihypertensive and lipid-lowering agents, left ventricular hypertrophy, and cardiovascular disease), those with cancer were more likely to have prevalent AF than those without cancer (odds ratio 1.19, 95% confidence interval 1.02 to 1.38). Subgroup analyses by age, sex, race, cardiovascular disease, and C-reactive protein yielded similar results. In conclusion, AF was more prevalent in participants with a history of non-life-threatening cancer and those who did not require active cancer treatment in REGARDS.
authors.affiliation: Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Electronic address: woneal@wakehealth.edu.
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.affiliation: Department of Medicine, Vermont Cancer Center, University of Vermont, Burlington, Vermont.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Lakoski
authors.affiliation: Section on Cardiology, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Waqas
authors.initials: W
authors.lastname: Qureshi
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: George
authors.initials: G
authors.lastname: Howard
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.affiliation: Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington, Vermont; Department of Pathology, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington, Vermont.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.affiliation: Section on Cardiology, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
mesh_terms: D017677:Age Distribution; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D002423:Cause of Death / Q000639:trends; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D044469:Racial Groups; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology