Cancer incidence and mortality in patients diagnosed with heart failure: results from an updated systematic review and meta-analysis

Cardio-Oncology

Research

Rocco Antonio Montone¹  Marco Lombardi²  Filippo Crea³  Antonella Lombardo³  Massimiliano Camilli³  Marco Giuseppe Del Buono³  Juan Guido Chiabrando⁴  Giorgio Minotti⁵ 

[1] Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128, Rome, Italy;Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00128, Rome, Italy;Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00128, Rome, Italy;Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00128, Rome, Italy;Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina;Department of Medicine, Center for Integrated Research and Unit of Drug Sciences, Campus Bio-Medico University and Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy;

关键词: Heart failure;    Cancer incidence;    Cancer mortality;    Systematic review;    Meta-analysis;    Cardio-oncology;   

DOI  :  10.1186/s40959-023-00158-1

 received in 2022-12-03, accepted in 2023-01-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSeveral cohort studies aimed at demonstrating an increased risk of cancer incidence and mortality in patients with a pre-existing diagnosis of heart failure (HF); however, conflicting results have been reported that call for systematic review and meta-analysis.MethodsWe conducted a systematic search of multiple databases from their inception through July 2022 and retrieved only papers reporting hazard ratios (HR). Random and fixed-effects models were fit for the study duration.ResultsThe analysis included nine cohort studies for a total of 515′041 HF cases and 1′365’452 controls without HF. Although high heterogeneity among studies was observed, the HR for incident cancer in HF patients was statistically significant (1.45, 95% CI 1.31–1.61, p < 0.0001), which was confirmed by sensitivity analyses; however, by analyzing the few papers reporting HRs for cancer mortality, no significant difference between HF and non-HF patients could be detected (HR 2.03, 95% CI [0.93–4.43], p = 0.0736). Further scrutiny of studies with adjusted HRs, when available, confirmed that cancer incidence was significantly increased in patients with HF, as was cancer mortality as well.ConclusionsThis meta-analysis shows that HF patients are at an increased risk of incident cancer. Increased mortality could not be firmly demonstrated by the available data. Our results call for inclusion of cancer-related endpoints in HF trials to adequately address this important clinical issue.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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