Title Page
Contents
ABSTRACT 9
Ⅰ. Introduction 12
1.1. Risk of cardiovascular disease in breast cancer patients 12
1.2. Clinical impact of Atrial fibrillation (AF) on breast cancer patients 12
1.3. Previous studies on risk factors of AF in breast cancer patients 13
1.4. Purpose 14
Ⅱ. Method 15
2.1. Study design 15
2.2. Data Collection 15
2.3. Study Outcome 16
2.4. Statistical analysis 17
2.5. Development of risk scoring system 18
Ⅲ. Result 19
3.1. Baseline characteristics 19
3.2. Clinical impact of AF 27
3.3. Risk factors of AF in breast cancer patients 27
3.4. Development of a novel risk prediction model for AF among BC patients and internal validation 34
Ⅳ. Discussion 38
4.1. Main finding 38
4.2. Clinical importance of AF in breast cancer survivorship. 39
4.3. The distinct nature of breast cancer survivorship care: The intersection of cardiovascular and cancer-related risk factors. 39
4.4. The Link Between Cancer-Related Risk Factors and AF in Breast Cancer Patients. 40
4.5. Clinical implication 42
4.6. Limitations 44
Ⅴ. Conclusion 45
References 47
국문 초록 54
Table 1. Baseline characteristics 21
Table 2. Baseline characteristics according to presence of AF 23
Table 3. Cardiovascular events according to presence of AF. 26
Table 4. Cox Regression Model for incident AF development after cancer diagnosis. 31
Table 5. Adjusted hazard ratios of cancer-related factors for early-onset and late-onset atrial fibrillation after breast cancer diagnosis 33
Table 6. Penalized Cox Regression Model with Cross Validation Approach for incident AF and risk score system for incident AF 35
Figure 1. Kaplan-Meier curves for MACE-free survival after breast cancer diagnosis categorized by presence of AF. MACE indicates major adverse... 30
Figure 2. Adjusted Hazard ratios of AF* for clinical outcomes. 30
Figure 3. Comparison of C-indexes between predictive models: a model with conventional risk factors vs. a model integrating both conventional and cancer-... 36
Figure 4. Kaplan-Meier curves for AF-free survival after breast cancer therapy according to risk stratification by the risk score system. 37
Figure 5. Contribution of cancer-related and conventional risk factors to the development of AF. 43