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Prevalence and incidence of various Cancer subtypes in patients with heart failure vs matched controls.

Authors
  • Schwartz, Brian1
  • Schou, Morten2
  • Gislason, Gunnar H3
  • Køber, Lars4
  • Torp-Pedersen, Christian5
  • Andersson, Charlotte6
  • 1 Department of Medicine, Section of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. Electronic address: [email protected]
  • 2 Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark. , (Denmark)
  • 3 Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University, Gentofte, Denmark; The Danish Heart Foundation, Copenhagen, Denmark. , (Denmark)
  • 4 The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. , (Denmark)
  • 5 Departments of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Hillerød, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. , (Denmark)
  • 6 Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark; Department of Medicine, Section of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. , (Denmark)
Type
Published Article
Journal
International journal of cardiology
Publication Date
Oct 01, 2020
Volume
316
Pages
209–213
Identifiers
DOI: 10.1016/j.ijcard.2020.05.035
PMID: 32446924
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Patients with heart failure (HF) may be at increased risks of cancer, but the magnitude of risk for various cancer subtypes is insufficiently investigated. Using the Danish Nationwide administrative databases between 1997 and 2017, we estimated the prevalence, incidence and relative risk for all-cause cancer in new-diagnosed HF vs. age and sex-matched controls (up to 5 controls per HF case) before and after adjustment for comorbidities. Among the 167,633 people in the heart failure group and 837,126 individuals in the control group, there was a higher prevalence of several comorbidities, including cancer (17% vs. 10%) in the HF group; odds ratio 1.72 (1.70-1.75). Patients with heart failure also had higher cancer incidence (cancer incidence rate 3.02 [2.97-3.07] per 100 person-years), compared with controls (cancer incidence rate 1.89 [1.88-1.90]); hazards ratio 1.38 (1.36-1.40). However, after adjustment for comorbidities the increased risk of malignancy was greatly attenuated (hazards ratio 1.14 [1.12-1.16] for incident all-cause cancer) and dissipated altogether after additional adjustment for medications (multivariable adjusted hazards ratio 0.93 [0.91-0.96] for all-cause cancer). In a homogeneous cohort of patients with ischemic heart disease, the increased risk of all-cause cancer was only marginally increased after adjustment for baseline comorbidities (hazards ratio 1.05 [1.02-1.08]). Patients with heart failure had a slightly increased risk of various cancer subtypes, but the risks were mainly driven by comorbidities. Copyright © 2020 Elsevier B.V. All rights reserved.

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