Cancer in patients with heart failure: Incidence, risk factors and prognostic impact

Sagastagoitia-Fornie, Marta; Barge‐Caballero, Eduardo; Barge‐Caballero, Gonzalo; Couto‐Mallón, David; Paniagua‐Martin, María J.; Enríquez-Vázquez, Daniel; Blanco-Canosa, Paula; Grille-Cancela, Zulaika; Muñiz, Javier; Vázquez‐Rodríguez, José Manuel; Crespo‐Leiro, María G.

doi:10.1016/j.ejim.2022.09.008

Cited by 3 publications

(2 citation statements)

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“…In contrast to recent studies suggesting a higher risk of cancer in patients with HF, 16,17,19,29 this long-term prospective study did not show an association between HF and cancer risk in patients who survived ACS using the basic Cox survival analysis. A more profound competing regression analysis even demonstrated an inverse association where neoplastic risk is higher among patients without HF at index hospitalization for ACS as compared with those with signs of HF.…”

Section: Discussioncontrasting

confidence: 99%

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9^† Study on heart disease

Mahmoud,

Berton,

Cordiano

et al. 2024

ESC Heart Failure

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AimsA higher risk of cancer among patients with heart failure (HF) has been suggested in recent community‐based studies. This study aimed to investigate the impact of HF during hospitalization with acute coronary syndrome (ACS) on the long‐term cancer risk.Methods and resultsThe study included 572 patients admitted with ACS to three Italian hospitals, discharged cancer‐free, and prospectively followed for 24 years or until death. All but three patients completed the follow‐up, which represented 6440 person‐years (mean age: 66 ± 12 years; 70% males). Baseline HF was diagnosed in 192 (34%) patients. A total of 129 (23%) patients developed cancer (103 without HF and 26 with HF), and 107 (19%) patients died due to it (81 without HF and 26 with HF). The incidence rates for cancer onset and cancer death were not different according to HF status. Cox regression analysis revealed no association between HF or left ventricular ejection fraction (LVEF) and cancer risk. In addition, no difference in cancer risk was observed among patients with HF with preserved ejection fraction, HF with mildly reduced ejection fraction, and HF with reduced ejection fraction. In competing risk regression analysis, the risk of cancer onset associated with HF was sub‐hazard ratio (SHR) 0.47 [95% confidence interval (CI): 0.30–0.72; P = 0.001] and SHR 1.02 (95% CI: 1.01–1.04; P = 0.002) with LVEF. Results were the same in the adjusted model. Yet the fully adjusted model showed an attenuated association between cancer death and HF (SHR: 0.63; 95% CI: 0.37–1.05; P = 0.08) and LVEF (SHR: 1.02; 95% CI: 0.99–1.06; P = 0.08). Consistent results were obtained after using propensity score matching analysis that created 192 pairs. A negative interaction between age and HF and a positive interaction between age and LVEF for cancer risk have also been found.ConclusionsAn inverse association between baseline HF and long‐term cancer risk has been observed among the ABC Study on heart disease patients who were followed for 24 years after ACS.

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Section: Discussioncontrasting

confidence: 99%

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9^† Study on heart disease

Mahmoud,

Berton,

Cordiano

et al. 2024

ESC Heart Failure

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“…Due to numerous factors, including study methodology, participant count, follow-up duration, geographic heterogeneity, demographic characteristics, and the specific types of cancer under investigation, the association between HF and the risk of developing cancer remains a topic of ongoing controversy [19]. Several studies have shown that HF is associated with an increased risk of malignancy [20][21][22][23]. Nevertheless, Irene Fernández-Ruiz and colleagues, after analyzing numerous factors, demonstrated that HF is not associated with general cancer, localized cancer or cancer-specific mortality [24,25].…”

Section: Introductionmentioning

confidence: 99%

Mendelian randomization combined with multi-omics explores the relationship between heart failure and cancer

Sun,

Mei,

et al. 2024

J. Cancer

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Background : Whether there is an association between HF (HF) and cancer has not been conclusively established, and it is not clear whether patients with cancer can share similar hospitalization strategies and outcomes with patients with HF. Methods: Genome-wide association summary statistics were performed using a two-sample Mendelian randomization (MR) method for HF patients and cancer patients from the GWAS directory, with co-localization and Summary Data-Based Mendelian Randomization (SMR) analyses to identify HF-associated genes, and transcriptomic analyses to analyze the roles of these genes in the clinical diagnosis and targeted therapies of multiple cancer types. Results: Two-sample MR analysis showed that increased risk of HF was associated with decreased risk of cervical, brain, breast, colorectal, lung, and skin cancers, and co-localization combined with SMR analysis identified ABO and SURF1 as HF-associated genes, and transcriptomic analyses showed that ABO is a risk factor for HF and a protective factor against cancer, whereas SURF1 is a protective factor against HF and a protective factor against cancer. Conclusion: There was no causal relationship between heart failure and cancers (Cervical, brain, breast, colorectal, lung and skin cancers) risk factors, however there was a trend toward a negative causal relationship between heart failure and cancers (Cervical, brain, breast, colorectal, lung and skin cancers) occurrence.

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The association between pre-existing heart failure and cancer incidence: A systematic review and meta-analysis

Barbosa,

Cabrita,

Dias

et al. 2024

Revista Portuguesa de Cardiologia

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Cancer in patients with heart failure: Incidence, risk factors and prognostic impact

Cited by 3 publications

References 30 publications

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9^† Study on heart disease

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9^† Study on heart disease

Mendelian randomization combined with multi-omics explores the relationship between heart failure and cancer

The association between pre-existing heart failure and cancer incidence: A systematic review and meta-analysis

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Cancer in patients with heart failure: Incidence, risk factors and prognostic impact

Cited by 3 publications

References 30 publications

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9† Study on heart disease

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9† Study on heart disease

Mendelian randomization combined with multi-omics explores the relationship between heart failure and cancer

The association between pre-existing heart failure and cancer incidence: A systematic review and meta-analysis

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Product

Resources

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Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9^† Study on heart disease

Heart failure during acute coronary syndrome and the long‐term cancer risk: the ABC‐9^† Study on heart disease