| Objective Atrial fibrillation(AF)and malignant tumor are common diseases in clinic,and some of the risk factors of AF are also risk factors of malignant tumor.At present,some studies suggest that the diagnosis of new-onset AF is related to the diagnosis of follow-up malignant tumors.With the progress of population aging,the prevalence of AF and malignant tumors will increase year by year,and they will become an important burden of global health problems.Clinically,it is often seen that the same patient has both AF and malignant tumor.The purpose of this study is to explore the time relationship between new-onset AF and subsequent malignant tumor detection,calculate the detection density(DD,DD=number of cases during the observation period/person-year)of malignant tumors in different time periods and analyze the composition of different malignant tumors.Methods We included patients over or equal to 45 years of age in Beijing Hospital Medical record system from March,2000 to April,2019,with the first discharge diagnosis including both malignant tumor and AF(ICD-10 code).395 patients with AF diagnosed before malignant tumor were selected.The clinical data were analyzed retrospectively.Patients were divided into early detection group(T<3 months,n=83)and late detection group(T≥ 3 months,n=312)according to the time interval between the diagnosis of AF and subsequent malignant tumor detection.The late detection group was further divided into<1 year group(3 months ≤T<1 year,n=20),<3 years group(lyear≤T<3 years,n=64)and≥ 3 years group(T≥ 3 years,n=228).The DD of malignant tumors and the composition of different malignant tumors in different time periods were compared.Results1.Among the 395 patients,the average age was 73.6 ±8.5 years,including 243 males(61.5%),124 cases of coronary heart disease(31.4%),238 cases of hypertension(60.3%),100 cases of type 2 diabetes(25.3%),68 cases of heart failure(17.2%),64 cases of cerebral infarction(16.2%)。Antithrombotic therapy was performed in 149 cases(37.7%),antiplatelet therapy in 96 cases(24.3%),anticoagulation therapy in 68 cases(17.2%)and antiplatelet+anticoagulation therapy in 1 5 cases(3.8%).The average detection time was 0.1 year(0.003-0.227 year)in early detection group,8.2 years(0.250-49.863 years)in late detection group,0.5 year in<1 year group,1.8 years in<3 years group and 10.6 years in≥ 3 years group.2.The overall DD of malignant tumors in the early detection group was higher than that in the late detection group(0.99 VS 0.12).The detection density ratio(DDR)of malignant tumor DD in the early detection group over that in the late detection group was 8.1(95%CI:5.9-11.3).In the elderly patients with malignant tumors of lung,digestive system,genitourinary system and hematological system,the DD in the early detection group was significantly higher than that in the late detection group,and the DDR was higher with a value of 12.4(95%CI:6.4-23.9).6.1(95%CI:2.8-12.9),7.8(95%CI:3.8-16.1)and 9.2(95%CI:1.9-44.9),respectively.The DDR1,DDR2 and DDR3.the ratio of DD in the early detection group,<1 year group and<3 years group over≥ 3 years group were 10.6(95%CI:7.6-14.8),0.7(95%CI:0.4-1.1)and 0.9(95%CI:0.6-1.1),respectively.3.The common malignant tumors sites in the early detection group and the late detection group were lung,digestive system and genitourinary system,accounting for 41.0%,18.1%and 21.7%of the early detection group,and 25.0%,28.5%and 22.8%of the late detection group,respectively.In the early detection group,there were more malignant tumors in the lung(P=0.004),but there was no significant difference in other sites.Lung malignant tumors were most frequently detected in the early detection group(34 cases,41.0%),digestive system malignant tumors were most frequently detected in<1 year group(7 cases,35.0%),genitourinary system malignant tumors were most frequently detected in<3 years group(16 cases,25.0%),and digestive system malignant tumors were most frequently detected in≥ 3 years group(70 cases,30.7%).The percentage of lung malignant tumors in the early detection group was significantly higher than that in the<3 years group(41%VS 20.3%,P<0.05).The differences in the composition of other malignant tumors among different time groups were not statistically significant.4.In the early detection group,there was no significant difference in the DD of malignant tumors between antithrombotic and non-antithrombotic groups(0.84 VS 1.09),DDR was 0.76(95%CI:0.4-1.4).In the late detection group,there was no significant difference in DD between antithrombotic group and non-antithrombotic group(0.12 VS 0.12),DDR was 0.98(95%CI:0.8-1.3).No matter which antithrombotic method was applied,the DD in the early detection group was higher than that in the late detection group,and DDR was 6.7(95%CI:3.4-13.3)in antiplatelet group,5.5(95%CI:2.4-12.7)in anticoagulant group,2.2(95%CI:0.2-22.1)in antiplatelet+anticoagulant group,6.9(95%CI:4.0-11.9)in antithrombotic group and 8.9(95%CI:5.9-13.4)in non-antithrombotic group.The common sites of malignant tumors detected in patients with and without antithrombotic therapy were lung,digestive system and genitourinary system.There was no significant difference in the composition of malignant tumors.Conclusions1.The DD of malignant tumors in the early detection group is higher than that in the late detection group,<1 year group,<3 years group and≥ 3 years group,and in the elderly patients with malignant tumors of lung,digestive system,genitourinary system and hematological system,the DD in the early detection group is significantly higher than that in the late detection group.2.The common malignant tumor sites were lung,digestive system and genitourinary system in both early detection group and late detection group,and the percentage of lung malignant tumors in early detection group was significantly higher than that in late detection group and<3 years group.3.In early and late detection groups,there was no significant difference in DD between antithrombotic group and non-antithrombotic group.Whether or not antithrombotic therapy was applied and what kind of antithrombotic therapy was applied,the DD of early detection group was higher than that of late detection group,and the common sites of malignant tumors detected in patients with antithrombotic therapy and non-antithrombotic therapy were lung,digestive system and genitourinary system. |
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