Characteristics and prognosis of patients with cancer in heart failure population

Background

Cancer and heart failure (HF) have a complex relationship. Cancer therapies cause heart failure, but recent studies show that existing heart failure may also increase cancer risk. Both diseases share common risk factors and inflammation seem to play a key role in the pathophysiology of both.

The aim of our study was to investigate the differences between patients with and without cancer in a heart failure cohort.

Methods

Data from a nationwide database of hospitalizations due to heart failure between 2015 and 2023 were retrieved. Cancer patients were identified with International Classification od Diseases 10th Revision codes C00 – C96 and D10 – D36 at discharge. Data about comorbidities, death and recurrent hospitalizations were collected.

Results

A total of 24,559 patients were included, 13,412 (54.6 %) were women, mean age 79.2 ± 10.8 years. Arterial hypertension was present in 12,207 (49.7 %), diabetes mellitus in 6,515 (26.5 %), hyperlipidaemia in 3,570 (14.5 %), atrial fibrillation in 12,692 (51.7 %) and chronic kidney disease in 8,716 (35.5 %) participants. A total of 6,210 (25.3 %) patients had a history of coronary artery disease, 1,598 (6.5 %) had a history of cerebrovascular disease and 1,919 (7.8 %) had a history of peripheral artery disease. Cancer was present in 2,065 (8.4 %) of our study group. Patients with heart failure and cancer were more likely men, were older and had more comorbidities as well as a higher number of rehospitalizations and death (table). In the multivariate Cox regression model cancer was associated with a higher rate of rehospitalization (HR 1.08, 95% CI: 1.01 – 1.15) and death (HR 1.52, 95% CI: 1.44 – 1.60) (figure).

Conclusion

Our study shows that patients with HF and cancer are older and have more comorbidities. Moreover, they are at higher risk for rehospitalization and death which underlines the importance of dedicated cardio-oncology research and clinical teams for targeted interventions in this subpopulation of patients with HF.TableFor image description, please refer to the figure legend and surrounding text.FigureFor image description, please refer to the figure legend and surrounding text.