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. 2022 Jan 24;11(3):571.
doi: 10.3390/jcm11030571.

Cancer Impacts Prognosis on Mortality in Patients with Acute Heart Failure: Analysis of the EPICTER Study

Manuel Méndez-Bailón  1 , Noel Lorenzo-Villalba  2 , Miriam Romero-Correa  3 , Esther Guisado-Espartero  4 , Juan González-Soler  5 , Jessica Rugeles-Niño  6 , Angel Sebastián-Leza  7 , Luis Ceresuela-Eito  8 , Verónica Romaní-Costa  9 , Angustias Quesada-Simón  10 , Llanos Soler-Rangel  11 , Almudena Herrero-Domingo  12 , Luis Díez-García  13 , José Alcalá-Pedrajas  14 , María Villalonga-Comas  15 , Emmanuel Andrès  2 , Diego Gudiñ-Aguirre  16 , Francesc Formiga  17 , Oscar Aramburu-Bodas  18 , Jose Arias-Jiménez  18 , Prado Salamanca-Bautista  18   19 , On Behalf Of Epicter Study Group
Affiliations

Cancer Impacts Prognosis on Mortality in Patients with Acute Heart Failure: Analysis of the EPICTER Study

Manuel Méndez-Bailón et al. J Clin Med. .

Abstract

Introduction: Heart failure (HF) and cancer are currently the leading causes of death worldwide, with an increasing incidence with age. Little is known about the treatment received and the prognosis of patients with acute HF and a prior cancer diagnosis.

Objective: to determine the clinical characteristics, palliative treatment received, and prognostic impact of patients with acute HF and a history of solid tumor.

Methods: The EPICTER study ("Epidemiological survey of advanced heart failure") is a cross-sectional, multicenter project that consecutively collected patients admitted for acute HF in 74 Spanish hospitals. Patients were classified into two groups according to whether they met criteria for acute HF with and without solid cancer, and the groups were subsequently compared. A multivariable logistic regression analysis was conducted, using the forward stepwise method. A Kaplan-Meier survival analysis was performed to evaluate the impact of solid tumor on prognosis in patients with acute HF.

Results: A total of 3127 patients were included, of which 394 patients (13%) had a prior diagnosis of some type of solid cancer. Patients with a history of cancer presented a greater frequency of weight loss at admission: 18% vs. 12% (p = 0.030). In the cancer group, functional impairment was noted more frequently: 43% vs. 35%, p = 0.039). Patients with a history of solid cancer more frequently presented with acute HF with preserved ejection fraction (65% vs. 58%, p = 0.048) than reduced or mildly reduced. In-hospital and 6-month follow-up mortality was 31% (110/357) in patients with solid cancer vs. 26% (637/2466), p = 0.046.

Conclusion: Our investigation demonstrates that in-hospital mortality and mortality during 6-month follow-up in patients with acute HF were higher in those subjects with a history of concomitant solid tumor cancer diagnosis.

Keywords: acute heart failure; cancer; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curve between acute heart failure in patients with and without cancer.
See this image and copyright information in PMC

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