Increased cancer incidence in patients with pre-existing heart failure: results from a French nationwide cohort study.

IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Mariana Mirabel, Camille Nevoret, Orianne Domengé, Corinne Emery, Rudolf A De Boer, Jean-Philippe Empana, Jean-Sébastien Hulot
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引用次数: 0

Abstract

Background and aims: There is conflicting evidence as to whether patients with pre-existing heart failure (HF) are at increased risk of developing cancer, especially because of common risk factors. We aimed to assess the incidence of cancer in patients with pre-existing HF compared with patients without known HF.

Methods: The French National Administrative Health Data System, containing all healthcare information for 99% of the French population, was used to identify adult patients with a first diagnosis of HF between 2010 and 2019 and without a history of cancer before HF diagnosis. HF patients were matched for sex and age to HF-free and cancer-free individuals (3:1 ratio).

Results: We found 330,867 HF patients, and 992,601 matched controls (54.7% women, mean age 77.7±13.5 years). A first cancer was diagnosed in 28,151 (8.5%) HF patients over a mean follow-up of 4.3±2.8 years compared to 77,325 (7.8%) in the controls over 4.9±2.8 years of follow-up (unadjusted subdistribution HR, sHR: 1.12 [1.11-1.13], P<0.001). The higher risk of new cancer in HF patients remained after full adjustment for major comorbidities, age, sex, year of diagnosis, region of residence, tobacco use and alcohol consumption (adjusted sHR=1.06, [1.04-1.07]; P<0.0001). Overall, the calculated attributable risk of new cancer after HF was 16.5% (9.9-16.8%). This increased risk was observed for most solid malignancies (especially colorectal and lung cancer), and for multiple myeloma.

Conclusions: Patients with a history of HF have a higher risk of developing cancer than the general population. Cancer screening strategies should be advocated in patients with HF.

既往心力衰竭患者癌症发病率增加:来自法国全国队列研究的结果。
背景和目的:关于既往心力衰竭(HF)患者发生癌症的风险是否增加,特别是由于常见的危险因素,目前存在相互矛盾的证据。我们的目的是评估已有心衰患者与已知无心衰患者的癌症发生率。方法:法国国家行政卫生数据系统包含99%法国人口的所有医疗保健信息,用于识别2010年至2019年间首次诊断为HF且在HF诊断前无癌症史的成年患者。HF患者按性别和年龄与无HF和无癌症的个体匹配(3:1的比例)。结果:我们发现了330,867例HF患者和992,601例匹配的对照组(54.7%为女性,平均年龄77.7±13.5岁)。在平均4.3±2.8年的随访中,28,151例(8.5%)HF患者被诊断为首次癌症,而在4.9±2.8年的随访中,对照组为77,325例(7.8%)(未经调整的亚分布HR, sHR: 1.12 [1.11-1.13], p)。结论:有HF病史的患者发生癌症的风险高于一般人群。心衰患者应提倡癌症筛查策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European journal of preventive cardiology
European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
12.50
自引率
12.00%
发文量
601
审稿时长
3-8 weeks
期刊介绍: European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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