A retrospective cohort study matched the age, gender, diabetic status, obesity, and frequency of annual visits to determine the overall and specific types of cancer incidence in 100,124 patients with heart failure and 100,124 without heart failure. I investigated. Diagnosis was made in more than 1000 general practice in Germany between January 2000 and December 2018. The mean (SD) patient age in both groups was 72.6 (12.2) years, most of them 71-80 years (34.9%, heart failure group, 35.2%, non-heart failure group), with diabetes being the most common comorbidity. (37.4% in both groups). The data were provided by IQVIA’s Disease Analysis Database.
“This is an observational study and the results do not prove that heart failure causes cancer,” said senior authors Mark Rude, PD Dr, MHBA, and Kiel’s Christian Albrecht University in Cardiology. Bremerhaven, Germany said. In the statement.. “But the findings suggest that patients with heart failure may benefit from cancer prophylaxis.”
Recognizing the importance of comorbidity often found in individuals with heart failure, the authors write that cancer has received increasing attention lately, but requires additional data “especially with respect to individual tumor types.” It was.
During a 10-year follow-up period, the authors analyzed heart failure and non-heart failure groups (all). P <.001), respectively:
- Overall incidence of cancer: 25.7% vs 16.2%
- Overall incidence of female patients: 28.6% vs. 18.8%
- Overall incidence of male patients: 23.2% vs. 13.8%
There was also a statistically significant association with cancer incidence (all). P <.001):
- The overall hazard ratio (HR) was 1.76 (95% CI, 1.71-1.81).
- Cancer risk increased by 85% in female patients with heart failure (HR, 1.85; 95% CI, 1.77-1.92)
- Cancer risk in male patients increased by 69% (HR, 1.69; 95% CI, 1.63-1.76)
Nine specific cancer types were also investigated, and the authors saw the following incidence among patients with heart failure:
- 110% higher risk of cancer of the lips, oral cavity and pharynx (HR, 2.10; 95% CI, 1.66-2.17)
- 91% higher risk of respiratory cancer (HR, 1.91; 95% CI, 1.74-2.10)
- The risk of genital cancer in female patients is 86% higher (HR, 1.86; 95% CI, 1.56-2.17).
- 83% higher risk of skin tumors (HR, 1.83; 95% CI, 1.72-1.94)
- 77% higher risk of lymphatic and hematopoietic tissue cancer (HR, 1.77; 95% CI, 1.63-1.91)
- 75% higher risk of gastrointestinal cancer (HR, 1.75; 95% CI, 1.64-1.87)
- 67% higher risk of breast cancer (HR, 1.67; 95% CI, 1.52-1.84)
- 64% higher risk of genitourinary cancer (HR, 1.64; 95% CI, 1.48-1.81)
- 52% higher risk of male genital cancer (HR, 1.52; 95% CI, 1.40-1.66)
“The particularly high incidence of oropharyngeal cancer in patients with heart failure suggests that common extrinsic risk factors such as nicotine can trigger comorbidity,” the authors write. I will.
When speculating on possible reasons for the association between heart failure and cancer incidence, the authors write that the role of increased chronic inflammation or free radical formation, and that heart failure may promote tumor growth through upregulation of certain proteins. Animal studies suggest Serpin A3 and A1 assuming there is. Fibronectin, ceruloplasmin, and paraoxonase 1.
Further research to “clarify this relationship” they saw, with a particular focus on enhanced tumor screening, to better protect patients with heart failure and improve their cancer prognosis. Said it was necessary.
Roderburg C, Loosen SH, Jahn JK, and other heart failure are associated with an increased incidence of cancer diagnosis. ESC Heart Fail. Published online on June 28, 2021. doi: 10.1002 / ehf2.13421
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