Heart failure is associated with an increased risk of cancer

Sophia Antipolis – June 28, 2021: A study of over 200,000 people found that patients with heart failure are more likely to develop cancer than their peers without heart failure. The research is presented today at Heart Failure 2021, an online scientific congress of the European Society of Cardiology (ESC), 1 and published in ESC heart failure, a review of ESC.2

“This was an observational study and the results do not prove that heart failure causes cancer,” said author Dr Mark Luedde of Christian-Albrechts University in Kiel and joint cardiology practice Bremerhaven, Germany. “However, the results suggest that patients with heart failure may benefit from cancer prevention measures.”

Heart failure affects an estimated 65 million people worldwide.3 Some cancer patients develop heart failure as a result of cancer treatment.4 More recently, it has also been found that patients with heart failure heart disease may have a high incidence of cancer during their heart disease, but most studies have been small.5-8

The present study examined the association between heart failure and the development of new cancers in a large cohort. The study used information from the nationally representative Disease Analyzer database, which covers 1,274 general practices in Germany.

A total of 100,124 patients with heart failure and 100,124 people without heart failure were included in the analysis. Patients with heart failure and those without heart failure were individually matched by gender, age, obesity, diabetes, and consultation frequency. No participant had cancer at the start of the study. Statistical models were used to examine the association between heart failure and cancer incidence over 10 years.

The mean age of the study population was 72.6 years and 54% were women. During the 10-year observation period, the incidence of cancer was significantly higher in patients with heart failure (25.7%) compared to those without heart failure (16.2%). In women, the incidence of cancer was 28.6% in patients with heart failure and 18.8% in those without heart failure. Among men, the corresponding rates were 23.2% and 13.8%.

Heart failure was significantly associated with the incidence of cancer, with a relative risk of 1.76. The risk ratios for women and men were 1.85 and 1.69, respectively.

Significant associations were found between heart failure and all types of cancer evaluated. The greatest increased risk was observed for cancer of the lip, oral cavity and pharynx, with a risk ratio of 2.10, followed by cancer of the respiratory organs, with a risk ratio of 1.91 . The risk ratios for the other sites were 1.86 for cancer of the female genital organs, 1.83 for skin tumors, 1.77 for cancer of lymphoid and hematopoietic tissues, 1.75 for cancer of the digestive tract , 1.67 for breast cancer, 1.64 for genitourinary tract cancer and 1.52 for male genitalia. Cancer.

Dr Luedde said: “Our results allow us to speculate that there may be a causal relationship between heart failure and an increased rate of cancer. This is biologically plausible, as there is experimental evidence that factors secreted by the failing heart can stimulate tumor growth. . “7

He continued, “Although heart failure and cancer share common risk factors such as obesity and diabetes, these were taken into account in the pairing analysis. It should be noted that our database does not include information on smoking, alcohol consumption or physical activity, so we were not able to match them in the analysis. ”

Dr Luedde concluded: “It is common for cancer patients who have received heart-damaging drugs to be monitored for heart failure. Conversely, evidence is mounting to indicate that patients with heart failure might benefit from intensive monitoring of cancer development – for example, given the high incidence of both


Authors: ESC Press Service

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Notes to editor

Funding: None.

Disclosures: None.

References and Notes

1 Abstract title: Heart failure and co-morbidities.

2Roderburg C, Loosen SH, Jahn JK, et al. Heart failure is associated with an increased incidence of cancer diagnoses. ESC Heart Fail. 2021. doi: 10.1002 / ehf2.13421.

3Bragazzi NL, Zhong W, Shu J, et al. Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017. Eur J Prev Cardiol. 2021. doi: 10.1093 / eurjpc / zwaa147.

4Zamorano JL, Lancellotti P, Muñoz DR, et al. 2016 ESC Position Paper on Treatments for Cancer and Cardiovascular Toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur Heart J. 2016; 37: 2768-2801.

5Banke A, Schou M, Videbaek L, et al. Cancer incidence in patients with chronic heart failure: a long-term follow-up study. Eur J Heart Fail. 2016; 18: 260-266.

6Hasin T, Gerber Y, Weston SA, et al. Heart failure after myocardial infarction is associated with an increased risk of cancer. J Am Coll Cardiol. 2016; 68: 265-271.

7Bertero E, Canepa M, Maack C, Ameri P. Linking heart failure to cancer: baseline data and research perspectives. Circulation. 2018; 138: 735-742.

8Tini G, Bertero E, Signori A, et al. Cancer mortality in heart failure trials with reduced ejection fraction: a systematic review and meta-analysis. J Am Heart Assoc. 2020; 9: e016309.

About Heart Failure 2021 and the World Congress on Acute Heart Failure

Heart Failure is the annual meeting of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). # HeartFailure2021

About the Heart Failure Association

The Heart Failure Association (HFA) is a branch of the European Society of Cardiology (ESC). Its objective is to improve the quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.

About the European Society of Cardiology

The European Society of Cardiology brings together healthcare professionals from over 150 countries, working to advance cardiovascular medicine and help people live longer and healthier lives.

About ESC heart failure

ESC heart failure is the open access journal of the Heart Failure Association (HFA) of ESC.

Information for journalists on registering for Heart Failure 2021

Heart Failure 2021 will take place from June 29 to July 1 online. Explore the scientific program.

  • Free registration only applies to accredited press.
  • Credentials: a valid press card or appropriate assignment letter with proof of three recently published papers (cardiology or health related or referring to a previous ESC event). Read it CES media and embargo policy.
  • The ESC press service will check the documents and confirm by e-mail the validity of your press accreditation.
  • The decision of the ESC press office is final with respect to all press registration requests.

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