Prior History and Incidence of Cancer Impacts on Cardiac Prognosis in Hospitalized Patients With Heart Failure

Abstract

Background: Heart failure (HF) and cancer (CA) are becoming increasingly prevalent as the population ages. We aimed to evaluate prior history and occurrence of CA and its prognostic impact on HF. Methods and Results: Consecutive hospitalized HF patients (n=2,103) were divided into 2 groups according to prior history of CA: non-prior-CA group (n=1,828) and prior-CA group (n=275). Compared with the non-prior-CA group, the prior-CA group were older, and had higher prevalence of chronic kidney disease, anemia, and atrial fibrillation (P<0.05). In contrast, sex, other comorbidities, levels of natriuretic peptide and ejection fraction were comparable between groups. We focused on newly diagnosed CA after discharge for HF. In the follow-up period (median 623 days), 114 (6.2%) patients in the non-prior-CA and 17 (6.2%) patients in the prior-CA groups were newly diagnosed as having CA. Additionally, 83 (3.9%) CA-related patient deaths occurred (median 776 days). In the Kaplan-Meier analysis (median 1,037 days), not only all-cause death but also cardiac event rate was significantly higher in the prior-CA group than in the non-prior-CA group (log-rank P<0.01). In the Cox proportional hazard analysis, CA history was a predictor of cardiac event rate (HR 1.450, 95% CI 1.134-1.822), as well as all-cause death (HR 2.483, 95% CI 2.034-3.030). Conclusions: Prior-CA history was associated with high cardiac event and mortality rates. CA is notable comorbidity in HF patients.

Cancer and malnutrition were independently associated with a poor prognosis in patients with heart failure

“…Under these conditions, the prevalence of cancer in the hospitalized HF patients in our study was 16.6%. This is comparable to the value in a recent report (13.1%) from Fukushima Medical University Hospital in Japan [17] , which is also a designated cancer hospital. In contrast, it is much higher in comparison to the value reported by the National Cerebral and Cardiovascular Center in Japan (3.8%) [18] .…”

Prevalence and prognostic value of the coexistence of anaemia and frailty in older patients with heart failure

“…In addition, patients with anaemia and/or frailty were more likely to have history of cancer in the present study. Cancer investigations are needed for such patients because prior cancer history was associated with high cardiac event and mortality rates in hospitalized patients with HF 41 . Further detailed studies are required to address these issues and to guide future clinical decision making for the treatment of older HF patients.…”

Serum TRACP5b, a Marker of Bone Resorption, Is Associated With Adverse Cardiac Prognosis in Hospitalized Patients With Heart Failure

“…Comorbidities were defined in accordance with our previous studies. [17][18][19][20][21] Hypertension was defined as the prior use of antihypertensive drugs for treatment of hypertension, Dyslipidemia was defined as the prior use of cholesterol-lowering drugs, a triglyceride value of ≥ 150 mg/dL, a low-density lipoprotein cholesterol value of ≥ 140 mg/dL, and/or a high-density lipoprotein cholesterol value of < 40 mg/dL. CKD was defined as estimated glomerular filtration rate of less than 60 mL/min/1.73 m 2 using a three-variable Japanese equation.…”