Incidence of Atrial Fibrillation in Postmenopausal Women with Endometrial Cancer.

Mariana S. Parahuleva,Amar Mardini,Ekaterina Uchikova,Gerhild Euler,Nikoleta Parahuleva,Dora Terzieva,Julian Kreutz

doi:10.3390/jcm10020266

Abstract

Endometrial cancer (EC) has been associated with an increased risk of cardiovascular disease, including atrial fibrillation (AF). We performed a prospective, case-controlled analysis among 310 Bulgarian women with new-onset, histologically confirmed EC, free of AF at the baseline survey, and women with normal (senile) endometrium/endometrial hyperplasia as a control group (n = 205). The risk of AF as well as relationship of adiponectin (APN) and high sensitivity C-reactive protein (hs-CRP) levels with AF in women with EC were calculated by Cox proportional hazards models. During the mean follow-up of 2.5 ± 0.5 years, new-onset AF had occurred in 11.7% of women with EC vs. 5.8% in the control group (p < 0.01). The risk of AF was highest in the first 6 months after new-onset EC, with an incidence rate ratio (IRR) of 1.19 (95% CI 1.10–1.29; p = 0.01). Women with EC, who were obese (body mass index (BMI) > 30 kg/m2) and younger (age < 60) were found to be more likely to develop AF (HR 1.95; 95% CI 1.18–3.32; p = 0.05). APN levels were not significantly associated with new-onset AF (95% CI 0.87–1.21; p = 0.063). However, the secondary analysis showed evidence of APN–AF association when adjusted for BMI (2.05; 95% CI 1.04–4.04; p = 0.037). We conclude that EC was significantly associated with the incidence of AF.

Highlights

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice [1,2].The occurrence and development of AF are associated with changes in the atria’s electrical properties and structure, known as electrical and structural remodeling [1,2]
Numerous risk factors contribute to the development of AF, obesity—which leads to left atrial (LA) remodeling by various mechanisms—and metabolic risk factors loom as increasingly prominent contributors to cardiac dysrhythmia and are associated with a marked increase in the risk of developing
Single-center study with a relatively large cohort of 310 women with endometrial cancer (EC), we report an association between EC and an increased risk of AF after multivariable adjustment for clinical risk factors compared with the age-adjusted control population with non-cancerous endometrium (Table 1)

Summary

Introduction

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice [1,2].The occurrence and development of AF are associated with changes in the atria’s electrical properties and structure, known as electrical and structural remodeling [1,2]. Populationbased studies have described risk factors for AF, including age, diabetes, and hypertension [2,3]. Numerous risk factors contribute to the development of AF, obesity—which leads to left atrial (LA) remodeling by various mechanisms—and metabolic risk factors loom as increasingly prominent contributors to cardiac dysrhythmia and are associated with a marked increase in the risk of developing AF [7,8]. Recent studies suggest that patients with non-cardiovascular diseases such as cancer face a substantial risk of AF [9,10,11,12]. Identification of novel factors influencing the development of AF is critical to the understanding and future prevention of the disease. A new study has provided yet more evidence that survivors of endometrial cancer (EC)

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