Abstract 11852: Impact of Heart Failure on New Cancer Diagnosis and Cancer Mortality in Patients With Ischemic Heart Disease Who Underwent Percutaneous Coronary Intervention

Abstract

Background: Recently, it has been reported that heart failure may be associated with high risk for development of cancer. However, this theory is not definitive and more epidemiological data are needed. Here we investigated the impact of heart failure on the incidence of new cancer diagnosis and cancer mortality in patients with ischemic heart disease who underwent percutaneous coronary intervention (PCI). Methods and Results: Consecutive 1787 patients with ischemic heart disease who underwent PCI were enrolled. Patients were divided into two groups according to the presence or absence of heart failure, and followed up for incidence of new cancer diagnosis and mortality due to cancer. Patients with heart failure (n = 434) were older (73.4 vs. 68.0 years, P < 0.001) and had higher prevalence of comorbidities such as anemia (63.2 vs. 40.2%, P < 0.001), chronic kidney disease (61.4 vs. 40.3%, P < 0.001), atrial fibrillation (20.7 vs. 14.0%, P = 0.001) and stroke (21.8 vs. 15.8%, P = 0.004) than those without heart failure (n = 1353). The percentage of smokers did not differ between two groups (P = 0.374). During follow up period (mean of 1528 days), there were 142 new cancer diagnoses and 60 cancer deaths. Of 142 new cancers, gastrointestinal cancer was the leading site (39.4%), followed by lung cancer (14.1%), prostate cancer (11.3%), liver or biliary tract cancer (10.6%), hematologic cancer (9.9%) and others. The incidence of new cancer diagnosis and cancer mortality were significantly higher in patients with heart failure than in those without heart failure (P < 0.001 and P = 0.001, respectively). In the multivariate analyses after adjusting for confounding factors including smoking, heart failure was an independent predictor of new cancer diagnosis and cancer death (hazard ratio 2.22, P < 0.001 and hazard ratio 1.78, P = 0.036, respectively). Conclusion: Heart failure was associated with incidence of new cancer and cancer death in patient with ischemic heart disease.