Cancer Risk Higher in Patients With Heart Failure After a First Heart Attack

Cancer Risk Higher in Patients With Heart Failure After a First Heart Attack
Cancer Risk Higher in Patients With Heart Failure After a First Heart Attack

The risk of developing cancer increases in people who experience heart failure after their first heart attack compared with people who experience no heart failure after their first heart attack. Heart failure, which correlates with a higher mortality rate than other heart diseases, describes several conditions that affect the heart's structure and functionality.1

Researchers previously observed a 70% increase in risk of developing cancer in patients who experienced heart failure. In this study, researchers examined data from 1081 patients who experienced heart failure with a first heart attack or did not experience heart failure with the first heart attack. These patients experienced first heart attacks between November 2002 and December 2010.

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Follow-up was an average of 4.9 years, with 228 patients (21%) developing heart failure. Of the 228 patients who developed heart failure, 28 (12.3%) developed cancer. In the group that did not experience heart failure, 8.2% developed cancer. The average time from the first heart attack to a diagnosis of cancer was 2.8 years. The most frequently diagnosed cancers were hematologic, respiratory, and digestive.

At first, rates of cancer were similar between the 2 groups. By 1.5 years of follow-up, rates of cancer in patients with heart failure exceeded rates in patients without heart failure. This association remained even after adjusting for risk factors such as comorbidities, smoking, age, sex, body mass index, and diabetes.

Interpretation of the results is limited by the small sample size and small number of events, though the results are statistically significant.

Increased incidence of cancer in patients with heart failure did not appear related to the higher frequency of appointments with physicians and of diagnostic procedures that patients with heart failure undergo. Researchers suggested a lack of detection bias as most heart failure events occurred soon after initial heart attack and most cancer diagnoses occurred more than 1.5 years after a first heart attack.

"Cancer constitutes an enormous burden to society, and both cancer and heart failure are well-known causes of increased mortality," said Veronique Roger, MD, director of the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery in Rochester, Minnesota, and senior author of the study.

"Our research suggests an association between both diseases, and it's possible that as we learn more about how this connection works, we can prevent deaths. In the meantime, physicians should recognize this increased cancer risk for heart failure patients and follow guideline recommended surveillance and early detection practices."

Reference

1. Hasin T, Gerber Y, Weston SA, et al. Heart failure after myocardial infarction is associated with increased risk of cancer. J Am Coll Cardiol. 2016 Jul 19. doi:10.1016/j.jacc.2016.04.053. [Epub ahead of print]

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