Nav: Home

Heart failure after first heart attack may increase cancer risk

July 11, 2016

People who develop heart failure after their first heart attack have a greater risk of developing cancer when compared to first-time heart attack survivors without heart failure, according to a study today in the Journal of the American College of Cardiology.

Heart failure refers to a number of conditions that can affect the heart's structure and the way the heart works and, over time, make it harder for the heart to pump enough blood and oxygen to meet the body's needs. It is associated with a higher risk of death than other types of heart disease.

Death from heart failure can often be attributed to direct cardiac causes such as heart failure symptoms, inadequate blood supply and irregular heartbeats; however, the noncardiac causes of heart failure death, such as cancer, are becoming increasingly recognized as researchers learn more about their association with the disease.

While cancer is usually considered a separate cause of death from heart disease, studies have been conducted to determine an association between heart disease and an increased cancer risk. This group of researchers previously looked at increased risk of cancer among heart failure patients and showed a 70 percent increase in risk.

In this new study, they looked at cancer risk in patients who developed heart failure after their first heart attack. Researchers chose to compare those with and without heart failure after heart attack because these patient groups have a lot in common, including atherosclerosis, risk factors, treatments received and follow-up routines. The factors that may differ between the groups, such as older age, obesity, smoking and diabetes, are known and can be controlled for, providing for comparison groups that may provide more information on the impact of heart failure on subsequent cancer occurrence than other heart disease groups.

Researchers looked at records for 1,081 patients in Olmsted County, Minnesota, who had their first heart attack between November 2002 and December 2010. Patient data was from the Rochester Epidemiological Project.

After an average of 4.9 years of follow up, 228 patients, or 21 percent, were diagnosed with heart failure and 28 of those patients, or 12.3 percent, developed cancer. In comparison, 8.2 percent of patients without heart failure were diagnosed with cancer. The average time from first heart attack to cancer diagnosis was 2.8 years, with the most common cancers being respiratory, digestive and hematologic.

The analysis showed that the incidence of cancer was similar initially between those with and without heart failure, but after 1.5 years of follow up there were higher rates of cancer among patients with heart failure. An association between heart failure and cancer remained after adjusting for age, sex, comorbidities, smoking, BMI and diabetes.

The findings are statistically significant, but a limitation of the study is the small sample size and number of events. These findings also support the earlier study that showed a 70 percent increased risk of cancer among heart failure patients.

Researchers looked at whether the increased incidence of cancer in heart failure patients could be due to the more frequent doctor visits and diagnostic procedures that occur with heart failure patients, which could lead to cancer being diagnosed earlier or at all. However, the researchers determined that since most health care demands of heart failure patients occur early after diagnosis and most cancers were diagnosed after 1.5 years, this detection bias was not a major reason for more instances of cancer diagnosis in heart failure patients.

The influence of medication on cancer diagnosis was also studied. Patients who developed heart failure after heart attack were prescribed the same medications at discharge as those who were not, so researchers concluded treatment for heart attack was not likely responsible for the higher rate of cancer in heart failure patients.

"Cancer constitutes an enormous burden to society, and both cancer and heart failure are well-known causes of increased mortality," said Veronique Roger, M.D., senior author of the study and director of the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery in Rochester, Minnesota. "Our research suggests an association between both diseases, and it's possible that as we learn more about how this connection works, we can prevent deaths. In the meantime, physicians should recognize this increased cancer risk for heart failure patients and follow guideline recommended surveillance and early detection practices."

In a related editorial comment, Paolo Boffetta, M.D., M.P.H., associate director for population sciences at The Tisch Cancer Institute and chief of the Division of Cancer Prevention and Control of the at Mount Sinai in New York, addressed whether the increased risk of cancer in this group of heart failure patients warranted additional screening beyond what was recommended for the general public. The two most prominent cancers were digestive and respiratory, for which routing screening tests are not available.

Boffetta also said the predominance of these two cancers suggests "a role of shared risk factors, as both heart failure and cancer are associated with smoking and alcohol."
-end-
This study was supported by grants from the National Heart, Lung and Blood Institute and the National Institute on Aging. The authors of the study and the editorial comment have no disclosures to report.

The American College of Cardiology is a 52,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more, visit acc.org.

American College of Cardiology

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
New analytical technology to quantify anti-cancer drugs inside cancer cells
University of Oklahoma researchers will apply a new analytical technology that could ultimately provide a powerful tool for improved treatment of cancer patients in Oklahoma and beyond.
Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
Researchers have found that treating patients who have early stage non-small cell lung cancer with a type of radiotherapy called stereotactic body radiation therapy is associated with a small but increased risk of death from causes other than cancer.
Cancer expert says public health and prevention measures are key to defeating cancer
Is investment in research to develop new treatments the best approach to controlling cancer?
UI Cancer Center, Governors State to address cancer disparities in south suburbs
The University of Illinois Cancer Center and Governors State University have received a joint four-year, $1.5 million grant from the National Cancer Institute to help both institutions conduct community-based research to reduce cancer-related health disparities in Chicago's south suburbs.
Leading cancer research organizations to host international cancer immunotherapy conference
The Cancer Research Institute, the Association for Cancer Immunotherapy, the European Academy of Tumor Immunology, and the American Association for Cancer Research will join forces to sponsor the first International Cancer Immunotherapy Conference at the Sheraton New York Times Square Hotel in New York, Sept.

Related Cancer Reading:

The Emperor of All Maladies: A Biography of Cancer
by Siddhartha Mukherjee (Author)

Anticancer: A New Way of Life
by David Servan-Schreiber MD PhD (Author)

The Truth about Cancer: What You Need to Know about Cancer's History, Treatment, and Prevention
by Ty M. Bollinger (Author)

The Cancer-Fighting Kitchen, Second Edition: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery
by Rebecca Katz (Author), Mat Edelson (Author)

F*ck Cancer: A totally inappropriate self-affirming adult coloring book (Totally Inappropriate Series) (Volume 4)
by Jen Meyers (Author)

Radical Remission: Surviving Cancer Against All Odds
by Kelly A. Turner PhD (Author)

The Metabolic Approach to Cancer: Integrating Deep Nutrition, the Ketogenic Diet, and Nontoxic Bio-Individualized Therapies
by Dr. Nasha Winters ND FABNO L.Ac Dipl.OM (Author), Jess Higgins Kelley MNT (Author), Kelly Turner (Foreword)

Cancer Hates Tea: A Unique Preventive and Transformative Lifestyle Change to Help Crush Cancer
by Maria Uspenski (Author), Dr. Mary L. Hardy (Foreword)

The Cancer Revolution: A Groundbreaking Program to Reverse and Prevent Cancer
by Leigh Erin Connealy (Author)

Chris Beat Cancer: A Comprehensive Plan for Healing Naturally
by Chris Wark (Author)

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Dying Well
Is there a way to talk about death candidly, without fear ... and even with humor? How can we best prepare for it with those we love? This hour, TED speakers explore the beauty of life ... and death. Guests include lawyer Jason Rosenthal, humorist Emily Levine, banker and travel blogger Michelle Knox, mortician Caitlin Doughty, and entrepreneur Lux Narayan.
Now Playing: Science for the People

#491 Frankenstein LIVES
Two hundred years ago, Mary Shelley gave us a legendary monster, shaping science fiction for good. Thanks to her, the name of Frankenstein is now famous world-wide. But who was the real monster here? The creation? Or the scientist that put him together? Tune in to a live show from Dragon Con 2018 in Atlanta, as we breakdown the science of Frankenstein, complete with grave robbing and rivers of maggots. Featuring Tina Saey, Lucas Hernandez, Travor Valle, and Nancy Miorelli. Moderated by our own Bethany Brookshire. Related links: Scientists successfully transplant lab-grown lungs into pigs, by Maria Temming on Science...