Heart Failure During Acute Coronary Syndrome and the Long-Term Cancer Risk: The ABC-9 Study on Heart Disease
Authors' conclusion
An inverse association between baseline HF and long-term cancer risk has been observed among the ABC Study on heart disease patients who were followed for 24 years after ACS.
Study context
- Population
- Patients admitted with acute coronary syndrome (ACS), discharged cancer-free, followed 24 years
- Participants
- 572 patients6,440 person-years
- Exposure
- Heart failure (HF) vs no HF during ACS hospitalisation
- HFn = 192
- Outcome
- Long-term cancer risk (cancer onset and cancer death)
- Follow-up
- 24 years
Methodological details3 Italian hospitals, propensity-score matched analysis
- 3 Italian hospitals
- Propensity-score matched analysis
Main finding
As reported in the abstract
Cancer onset
No HF
103
events
HF
26
events
Subdistribution hazard ratio (95% CI)P value
HFvs No HF
0.47(0.30–0.72)
P = 0.001LVEF
1.02(1.01–1.04)
P = 0.002Observational data: associations, not effects.
Further findings
| Outcome | No HF | SHR (95% CI) | P value | |
|---|---|---|---|---|
| Cancer deathHFvs No HFFully adjusted model | 81 events | 0.63 (0.37–1.05) | P = 0.08 | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Cancer death
| SHR (95% CI) | P value | ||
|---|---|---|---|
| LVEFFully adjusted model | 1.02 (0.99–1.06) | P = 0.08 | |
| 0.512Subdistribution hazard ratio (log scale) |
- Cancer death: total cancer deaths 107 (19%)
Cancer risk by HF phenotype (HFpEF, HF with mildly reduced EF, HFrEF)
- No difference in cancer risk
Propensity-score matched analysis
- Consistent results (192 pairs)
Interactions with age
- Negative interaction between age and HF and positive interaction between age and left ventricular ejection fraction (LVEF) for cancer risk
Original publication
Heart Failure During Acute Coronary Syndrome and the Long-Term Cancer Risk: The ABC-9 Study on Heart Disease. ESC Heart Fail. Published 20 February 2024. doi:10.
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