eprintid: 293037 rev_number: 26 eprint_status: archive userid: 45630 dir: disk0/00/29/30/37 datestamp: 2023-02-28 16:02:51 lastmod: 2023-06-01 14:28:44 status_changed: 2023-02-28 16:02:51 type: article metadata_visibility: show creators_name: Dobbin, Stephen J.H. creators_name: Shen, Li creators_name: Petrie, Mark C. creators_name: Packer, Milton creators_name: Solomon, Scott D. creators_name: McMurray, John J.V. creators_name: Lang, Ninian N. creators_name: Jhund, Pardeep S. creators_orcid: 0000-0002-9111-0242 creators_orcid: 0000-0002-6333-9496 creators_orcid: 0000-0002-6317-3975 creators_orcid: 0000-0001-8441-6887 creators_orcid: 0000-0003-4306-5317 title: Characteristics and outcomes of patients with a history of cancer recruited to heart failure trials ispublished: pub divisions: 25200000 full_text_status: public abstract: Aims: Heart failure (HF) therapy trials usually exclude cancer patients. We examined the association between cancer history and outcomes in trial participants with HF and reduced (HFrEF) or preserved ejection fraction (HFpEF). Methods and results: We combined PARADIGM-HF and ATMOSPHERE, which enrolled HFrEF patients (n = 15 415) and we pooled HFpEF patients (ejection fraction ≥45%) enrolled in PARAGON-HF and CHARM-Preserved (n = 7363). The associations between cancer history, cardiovascular (CV) death, HF hospitalization, non-CV and all-cause death in these trials were examined. Incident cancer diagnoses during these trials were also measured. There were 658 (4.3%) and 624 (8.5%) patients with a cancer history in the HFrEF and HFpEF trials, respectively. HFrEF patients with a cancer history had a higher risk of HF hospitalization (adjusted hazard ratio [HR] 1.28; 95% confidence interval [CI] 1.07–1.52, p = 0.007) and non-CV death (adjusted HR 1.57; 95% CI 1.16–2.12, p = 0.003) than those without. The risks of other outcomes were similar. There were no differences in the risk of any outcome in HFpEF patients with and without a cancer history. Adjusting for age and sex, the incidence of new cancer in the HFrEF and HFpEF trials was 1.09 (95% CI 0.83–1.36) and 1.07 (95% CI 0.81–1.32) per 100 person-years, respectively. Conclusions: Although participants in HFrEF trials with a cancer history had higher risks of HF hospitalization and non-CV death than those without, the risks of CV and all-cause death were similar. Outcomes in HFpEF patients with and without a cancer history were similar. Incident cancer diagnoses were similar in HFrEF and HFpEF trials. date: 2023-04 date_type: published publication: European Journal of Heart Failure volume: 25 number: 4 publisher: Wiley pagerange: 488-496 id_number: 10.1002/ejhf.2818 refereed: TRUE issn: 1388-9842 copyright_holders: Copyright © 2023 The Authors prior: First published in European Journal of Heart Failure 25(4): 488-496 repro: Reproduced under a Creative Commons license uniqueid: glaseprints:2023-293037 issn_online: 1879-0844 funding_project_code: 303944 funding_project_name: BHF Centre of Excellence funding_investigator_name: Colin Berry funding_funder_name: British Heart Foundation (BHF) funding_funder_code: RE/18/6/34217 funding_investigator_dept: CAMS - Cardiovascular Science pubmed_id: 36919816 euro_pubmed_id: 36919816 hoa_compliant: 9215 hoa_ref_pan: AB hoa_date_acc: 2023-02-26 hoa_date_pub: 2023-03-15 hoa_date_foa: 2023-03-16 hoa_version_fcd: AM hoa_exclude: FALSE hoa_gold: TRUE oa_research_materials_ack: No rioxx2_license_ref_input_license_ref: https://creativecommons.org/licenses/by/4.0/ rioxx2_license_ref_input_start_date: 2023-03-15 citation: Dobbin, S. J.H. , Shen, L. , Petrie, M. C. , Packer, M., Solomon, S. D., McMurray, J. J.V. , Lang, N. N. and Jhund, P. S. (2023) Characteristics and outcomes of patients with a history of cancer recruited to heart failure trials. European Journal of Heart Failure , 25(4), pp. 488-496. (doi: 10.1002/ejhf.2818 ) (PMID:36919816) document_url: https://eprints.gla.ac.uk/293037/1/293037.pdf