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Evolution of death due to cancer in heart failure ambulatory patients during 17 years follow-up

Session Poster Session 3

Speaker Antonio Bayes Genis

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : P Moliner (Barcelona,ES), J Lupon (Barcelona,ES), M De Antonio (Barcelona,ES), M Domingo (Barcelona,ES), E Santiago-Vacas (Barcelona,ES), E Zamora (Barcelona,ES), B Gonzalez (Barcelona,ES), C Rivas (Barcelona,ES), V Diaz (Barcelona,ES), P Velayos (Barcelona,ES), J Santesmases (Barcelona,ES), C Diez-Quevedo (Barcelona,ES), M Boldo (Barcelona,ES), J Nunez (Valencia,ES), A Bayes-Genis (Barcelona,ES)

Authors:
P Moliner1 , J Lupon1 , M De Antonio1 , M Domingo1 , E Santiago-Vacas1 , E Zamora1 , B Gonzalez1 , C Rivas1 , V Diaz1 , P Velayos1 , J Santesmases1 , C Diez-Quevedo1 , M Boldo1 , J Nunez2 , A Bayes-Genis1 , 1Germans Trias i Pujol University Hospital - Badalona (Barcelona) - Spain , 2University Hospital Clinic of Valencia - Valencia - Spain ,

Citation:

Background: Cancer is one of the main causes of death in general population in developed countries together with cardiovascular causes. A bidirectional relationship between heart failure (HF) and cancer has been suggested. Cancer survivors carry a greater burden of  HF than the non-cancer population, while it increasingly appears that HF migh facilitate the development of cancer. Both entities share several risk factors which have the  common pathophysiological characteristic of chronic inflammation, which is associated with both cardiomyopathic and neoplastic processes. Indeed cancer treatment might favour HF while HF might preclude cancer treatment.

Purpose: To assess the incidence of cancer as cause of death since the year 2002 up to the year 2018 in ambulatory patients attended in a HF clinic.

Methods: Patients who died of unknown cause were excluded from the analysis. Cancer and other fatal events were identified from the clinical records of patients with HF, hospital wards, the emergency room, general practitioners, or by contacting the patient’s relatives. Furthermore, data were verified from the databases of the Catalan and Spanish Health Systems. Trends on cancer as cause of was were assessed by linear regression.

Results: Since August 2001 to May 2018, 2295 HF patients were admitted to the HF clinic (age 66.4 ± 12.8 years, 71% men, 49% from ischemic aetiology,  mean LVEF 35.2% ± 14). During the 17 years of the study, 1201 deaths were recorded. Seventy-eight patients (6.5% of deaths) were excluded due to unknown cause of death. Out of the other 1123 deaths, 149 were due to cancer. The percentage of cancer as cause of death by years is shown in the figure. A significant trend was observed  towards a progressive increase in cancer deaths over time (p=0.003).  

Conclusions: During the 17 years of the study, a very significant trend towards higher percentage of cancer deaths was progressively observed.

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