Increased risk of cancer death in patients with chronic heart failure with a special reference to inflammation-A report from the CHART-2 Study
| Autor: | Masanobu Miura, Chart Investigators, Yasuhiko Sakata, Ruri Abe, Kotaro Nochioka, Takashi Shiroto, Shintaro Kasahara, Koichiro Sugimura, Masayuki Sato, Satoshi Miyata, Hiroaki Shimokawa, Hajime Aoyanagi, Jun Takahashi, Takuya Oikawa |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Research Report medicine.medical_specialty 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Japan Risk Factors Neoplasms Internal medicine medicine Humans Prospective Studies 030212 general & internal medicine Myocardial infarction Mortality Stroke Aged Aged 80 and over Heart Failure Inflammation business.industry Proportional hazards model Incidence (epidemiology) Hazard ratio Cancer Atrial fibrillation Middle Aged medicine.disease C-Reactive Protein Heart failure Chronic Disease Female Inflammation Mediators Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 290:106-112 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2019.04.078 |
| Popis: | Although several factors, including heart failure (HF) and inflammation, are known to increase the incidence of cancer, it remains unknown whether HF may increase cancer mortality, especially with a reference to inflammation.We examined 8843 consecutive cardiovascular patients without a prior history of cancer in our CHART-2 Study (mean 68 yrs., female 30.9%). As compared with patients without HF (Stage A/B, N = 4622), those with HF (Stage C/D, N = 4221) were characterized by higher prevalence of diabetes, previous myocardial infarction, atrial fibrillation, and stroke. During the median 6.5-year follow-up (52,675 person-years), 282 cancer deaths occurred. HF patients had significantly higher cancer mortality than those without HF in both the overall (3.7 vs, 2.8%, hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.12-1.79, P = 0.004) and the propensity score-matched cohorts (HR 1.46, 95%CI 1.10-1.93, P = 0.008), which was confirmed in the competing risk models. The multivariable Cox proportional hazard model in the matched cohort showed that HF was associated with increased cancer mortality in patients with C-reactive protein (CRP) ≥ 2.0 mg/L (HR 1.87, 95%CI 1.18-2.96, P = 0.008) at baseline, but not in those with CRP 2.0 mg/L (HR 0.89, 95%CI 0.54-1.45, P = 0.64) (P for interaction = 0.03). Furthermore, temporal changes in CRP levels were associated with cancer death in the overall cohort; HF patients with CRP ≥ 2.0 mg/L at both baseline and 1-year had significantly increased cancer death, while those with CRP ≥ 2.0 mg/L at baseline and 2.0 mg/L at 1-year not.These results provide the first evidence that HF is associated with increased cancer death, especially when associated with prolonged inflammation. |
| Databáze: | OpenAIRE |
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