In abstracts presented at the 2024 American Society of Clinical Oncology’s annual meeting, researchers addressed the association between heart failure and multiple types of cancers.
In patients with colorectal cancer (CRC), congestive heart failure (HF) is widely prevalent and can exacerbate in-hospital mortality rates, length of stay (LOS) at hospitals, and health care utilization costs. For patients with lung cancer, however, the most significant groups at risk of HF are Black populations, older patients, and patients using Medicare insurance. Addressing underlying risk factors and using guideline-directed therapies are the first steps in improving outcomes in these groups.
According to the National Cancer Institute, CRC and lung cancer are the leading causes of cancer-related deaths in the US, with lung cancer constituting 20% of all cancer-related deaths and CRC with 9%.1
“Baseline demographic characteristics were analyzed to determine the disparities in the prevalence of HF in lung cancer patients,” wrote authors of an abstract presented at ASCO 2024, the American Society of Clinical Oncology’s annual meeting.2 Their goal was to stratify the patient population and determine the risk factors of HF for patients with CRC.
Similarly, the aim of another abstract presented at ASCO 2024 “was to investigate the impact of congestive HF on in-hospital mortality, hospital LOS, and total hospitalization charge among hospitalized patients with CRC,” wrote the authors.3
Aside from the 2 separate types of cancer being observed, 1 study was aimed at HF overall, while the other addressed congestive HF. Congestive HF is caused when blood flow is slowed down, creating congestion in the body’s tissues, and blood returning to the heart is backed up. The other types of HF, according to the American Heart Association, are right-sided and left-sided HF, dealing with either the left or right atrium and ventricle.4
Addressing the association of HF in patients with either type of cancer, both abstracts examined study groups with populations of well over 75,000 individuals.
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Starting with the relationship between HF and CRC, researchers analyzed 77,130 hospitalized patients with CRC. Of this entire population, 10.08% had comorbid congestive HF. Among these individuals with CRC, in-hospital mortality was 2.74%. However, in patients with both HF and CRC, mortality was significantly higher at 6.5%.2
“Congestive HF was found to be an independent predictor of increased in-hospital mortality, longer LOS, and higher total hospitalization charge,” they wrote.2
With 7755 out of the 77,000-person cohort experiencing congestive HF, researchers deemed it widely prevalent in patients with CRC. Furthermore, they found that congestive HF in these patients significantly worsened hospital outcomes. To improve these outcomes and overall mortality, researchers suggest swift diagnosis and management of HF among CRC patients.
“Early diagnosis and management of HF using guideline-directed medical therapy along with close follow up may improve outcomes. Further prospective multicentric studies are warranted to better describe these associations,” they concluded.2
In the second abstract, researchers examined 221,320 patients with lung cancer and 25,495 with concurrent HF. Compared to the White population, Black patients had increased odds of HF, while patients with Medicare insurance also had an increased chance of HF compared with individuals using Medicaid or private insurance.3
Furthermore, high-income patients had a decreased chance of experiencing HF and men were more likely to have HF than women.
Regarding comorbidities leading to risk of HF, hyperlipidemia had the greatest association, followed by obesity, diabetes, end-stage renal disease, and COPD. Hypertension, however, was associated with decreased chances of HF.
With HF significantly prevalent in patients with either CRC or lung cancer, researchers identified underlying risk factors as the most important aspects of improving outcomes and quality of life in these patients.
“Addressing underlying risk factors can enhance patient outcomes and promote overall quality of life,” they concluded.3
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