The online home for the primary care professionals managing patients with cardiovascular disease, diabetes and related diseases.

Heart failure more fatal than some common cancers

Heart failure more fatal than some common cancers

Publication date: Wednesday, 07 June 2017
Contributor(s): Jeremy Bray

Men and women suffering from heart failure have a higher risk of death than people with some common types of cancer, according to results from the primary care database study.

Anonymised data from over 58,000 patients was collected between 2000–2011 from 393 general practices in Scotland. The overall dataset used included patient information for approximately a third of the Scottish population and represented a mixture of age and gender, as well a range of people geographically and economically.

For men, the four most common cancers are prostate, lung, colorectal, and bladder; while for women, they are breast, colorectal, lung, and ovarian. Mortality outcomes were worse for men with heart failure  than prostate cancer and bladder cancer, but better than lung cancer and colorectal cancer, whereas women with heart failure had worse outcomes than those with breast cancer but better than colorectal, lung and ovarian cancers (Table). Diagnoses of cancer and heart failure were at similar ages in men, but women typically experienced heart failure later in life. Only 5.5% of either gender suffering from heart failure did not have another disease as well, compared to 20-38% of cancer patients.

Lead author Professor Mamas Mamas (Consultant Cardiologist, Royal Stoke Hospital) said, “The findings of this study are important, our study shows that despite advances in the treatment of heart failure with newer drugs and devices, mortality rates remain significant and heart failure remains as malignant as many of the common cancers.”

Men


Groups

Hazard ratio (95% CI)

5-year survival

Heart failure

(Reference group)

55.8%

Prostate cancer

0.61 (0.57–0.65)

68.3%

Bladder cancer

0.88 (0.81–0.96)

57.3%

Lung cancer

3.86 (3.65–4.07)

8.4%

Colorectal cancer

1.23 (1.16–1.31)

48.9%

Women


Groups

Hazard ratio (95% CI)

5-year survival

Heart failure

(Reference group)

49.5%

Breast cancer

0.55 (0.51–0.59)

77.7%

Colorectal cancer

1.21 (1.13–1.29)

51.5%

Lung cancer

3.82 (3.60–4.05)

10.4%

Ovarian cancer

1.98 (1.80–2.17)

38.2%

ACTION

Heart failure remains as serious as several common cancers, and is accompanied by many co-morbidities. Targeted management of heart failure and these co-morbidities will optimise survival and quality of life in this patient population.

Mamas M et al. Do patients have worse outcomes in heart failure than in cancer?  A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Failure 2017; doi 10.1002/ejhf.822 onlinelibrary.wiley.com/doi/10.1002/ejhf.822/full

Topics covered:
Category: Evidence in Practice
Edition: Volume 2 Number 5 PCCJ Online 2017
Contributor(s): Jeremy Bray

Article search and filter