Characteristics and outcomes of patients with cancer hospitalized with new onset acute heart failure.

Abstract

Aims: Limited evidence exists regarding the outcomes of cancer patients hospitalized with new onset acute heart failure (AHF). We assessed the in-hospital mortality and 1 year outcomes of cancer patients admitted for new onset AHF, taking into account both past and active cancer status as well as cancer site.

Methods: We examined administrative data of adult patients hospitalized with a first episode of AHF from 2003 to 2018 in Lombardy, Italy. Patients were categorized based on their cancer history. The primary endpoint was in-hospital mortality with secondary endpoints including 1 year all-cause mortality and 1 year re-hospitalization for AHF.

Results: Among 283 144 patients AHF hospitalizations, 55 145 (19%) involved patients with a history of cancer (60% past cancer, 40% active cancer). Both in-hospital and 1 year mortality rates were higher among cancer patients compared with those without (9.3% vs. 6.4% and 34.9% vs. 22.3%, respectively; P < 0.0001). After adjustment, cancer patients exhibited increased risk of in-hospital mortality [odds ratio (OR) 1.40; 99% confidence interval (CI) 1.34-1.46] and 1 year mortality (HR 1.35; 99% CI 1.32-1.39), particularly among those with lung cancer. Patients with active and past cancer had a similar in-hospital mortality risk (OR 0.99; 99% CI 0.91-1.07) while 1 year mortality risk was higher among those with active cancer (HR 1.26; 99% CI 1.21-1.31).

Conclusions: Cancer is a prevalent comorbidity in patients hospitalized with new onset AHF, and it is associated with a poorer prognosis. Mortality risk appears to vary based on cancer status and type.