Gender‐specific risks for incident cancer in patients with different heart failure phenotypes

Abstract Background There is conflicting evidence regarding whether heart failure (HF) increases the risk of developing cancer. Objective This study aimed to assess the association between HF and incident cancer, considering gender differences and HF phenotypes. Methods This retrospective study was...

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Main Authors: Qin‐Fen Chen, Christos S. Katsouras, Chenyang Liu, Jingjing Shi, Xiaoqian Luan, Chao Ni, Hongxia Yao, Yingdan Lu, Wei‐Hong Lin, Xiao‐Dong Zhou
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.15097
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author Qin‐Fen Chen
Christos S. Katsouras
Chenyang Liu
Jingjing Shi
Xiaoqian Luan
Chao Ni
Hongxia Yao
Yingdan Lu
Wei‐Hong Lin
Xiao‐Dong Zhou
author_facet Qin‐Fen Chen
Christos S. Katsouras
Chenyang Liu
Jingjing Shi
Xiaoqian Luan
Chao Ni
Hongxia Yao
Yingdan Lu
Wei‐Hong Lin
Xiao‐Dong Zhou
author_sort Qin‐Fen Chen
collection DOAJ
description Abstract Background There is conflicting evidence regarding whether heart failure (HF) increases the risk of developing cancer. Objective This study aimed to assess the association between HF and incident cancer, considering gender differences and HF phenotypes. Methods This retrospective study was conducted on data of adult individuals, free of cancer at baseline, from the First Affiliated Hospital of Wenzhou Medical University between January 2009 and February 2023. The patients with HF were categorized as HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). The primary outcome was incident cancer, including obesity‐related, tobacco‐related, lung, colorectal and breast cancers. Results Of 33 033 individuals enrolled, 16 722 were diagnosed with HF, including 10 086 (60.3%) with HFpEF and 6636 (39.7%) with HFrEF. During a median follow‐up period of 4.6 years (inter‐quartile range: 2.6–7.3), incident cancer was diagnosed in 10.5% (1707 patients) of the non‐HF group and 15.1% (2533 individuals) of the HF group. After adjusting for potential confounding factors, patients with HF had a 58% increased risk of cancer than those without HF [adjusted hazard ratio (HR) 1.58, 95% confidence interval (CI) 1.48–1.69, P < 0.001]. This risk was consistent across genders (female: adjusted HR 1.95, 95% CI 1.74–2.18, P < 0.001; male: adjusted HR 1.41, 95% CI 1.30–1.54, P < 0.001) and HF phenotypes (HFpEF: adjusted HR 1.69, 95% CI 1.57–1.81, P < 0.001; HFrEF: adjusted HR 1.32, 95% CI 1.20–1.46, P < 0.001). Conclusions Both HFpEF and HFrEF are associated with an increased risk of incident cancer. This correlation maintains its validity across genders.
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spelling doaj-art-586ac9c686bc4f519bb742b1b548bc212025-08-20T02:16:22ZengWileyESC Heart Failure2055-58222025-02-0112149750710.1002/ehf2.15097Gender‐specific risks for incident cancer in patients with different heart failure phenotypesQin‐Fen Chen0Christos S. Katsouras1Chenyang Liu2Jingjing Shi3Xiaoqian Luan4Chao Ni5Hongxia Yao6Yingdan Lu7Wei‐Hong Lin8Xiao‐Dong Zhou9Medical Care Center First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaFirst Department of Cardiology, University Hospital of Ioannina Faculty of Medicine, School of Health Sciences University of Ioannina Ioannina GreeceDepartment of Cardiovascular Medicine, the Heart Center First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaWenzhou Medical University Renji College Wenzhou ChinaInstitute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders Wenzhou Medical University Wenzhou ChinaInstitute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders Wenzhou Medical University Wenzhou ChinaDepartment of Cardiovascular Medicine, the Heart Center First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Cardiovascular Medicine, the Heart Center First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaMedical Care Center First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Cardiovascular Medicine, the Heart Center First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaAbstract Background There is conflicting evidence regarding whether heart failure (HF) increases the risk of developing cancer. Objective This study aimed to assess the association between HF and incident cancer, considering gender differences and HF phenotypes. Methods This retrospective study was conducted on data of adult individuals, free of cancer at baseline, from the First Affiliated Hospital of Wenzhou Medical University between January 2009 and February 2023. The patients with HF were categorized as HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). The primary outcome was incident cancer, including obesity‐related, tobacco‐related, lung, colorectal and breast cancers. Results Of 33 033 individuals enrolled, 16 722 were diagnosed with HF, including 10 086 (60.3%) with HFpEF and 6636 (39.7%) with HFrEF. During a median follow‐up period of 4.6 years (inter‐quartile range: 2.6–7.3), incident cancer was diagnosed in 10.5% (1707 patients) of the non‐HF group and 15.1% (2533 individuals) of the HF group. After adjusting for potential confounding factors, patients with HF had a 58% increased risk of cancer than those without HF [adjusted hazard ratio (HR) 1.58, 95% confidence interval (CI) 1.48–1.69, P < 0.001]. This risk was consistent across genders (female: adjusted HR 1.95, 95% CI 1.74–2.18, P < 0.001; male: adjusted HR 1.41, 95% CI 1.30–1.54, P < 0.001) and HF phenotypes (HFpEF: adjusted HR 1.69, 95% CI 1.57–1.81, P < 0.001; HFrEF: adjusted HR 1.32, 95% CI 1.20–1.46, P < 0.001). Conclusions Both HFpEF and HFrEF are associated with an increased risk of incident cancer. This correlation maintains its validity across genders.https://doi.org/10.1002/ehf2.15097cardio‐oncologycancerheart failureheart failure with reduced ejection fractionheart failure with preserved ejection fractionprognosis
spellingShingle Qin‐Fen Chen
Christos S. Katsouras
Chenyang Liu
Jingjing Shi
Xiaoqian Luan
Chao Ni
Hongxia Yao
Yingdan Lu
Wei‐Hong Lin
Xiao‐Dong Zhou
Gender‐specific risks for incident cancer in patients with different heart failure phenotypes
ESC Heart Failure
cardio‐oncology
cancer
heart failure
heart failure with reduced ejection fraction
heart failure with preserved ejection fraction
prognosis
title Gender‐specific risks for incident cancer in patients with different heart failure phenotypes
title_full Gender‐specific risks for incident cancer in patients with different heart failure phenotypes
title_fullStr Gender‐specific risks for incident cancer in patients with different heart failure phenotypes
title_full_unstemmed Gender‐specific risks for incident cancer in patients with different heart failure phenotypes
title_short Gender‐specific risks for incident cancer in patients with different heart failure phenotypes
title_sort gender specific risks for incident cancer in patients with different heart failure phenotypes
topic cardio‐oncology
cancer
heart failure
heart failure with reduced ejection fraction
heart failure with preserved ejection fraction
prognosis
url https://doi.org/10.1002/ehf2.15097
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