Mamas A Mamas1,2,3, Matthew Sperrin3, Margaret C Watson4, Alasdair Coutts5, Katie Wilde5, Christopher Burton6, Umesh T Kadam7, Chun Shing Kwok1,2,8, Allan B Clark9, Peter Murchie8, Iain Buchan3, Philip C Hannaford8, Phyo K Myint8. 1. Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK. 2. Academic Department of Cardiology, Royal Stoke Hospital, University Hospital North Midlands, Stoke-on-Trent, UK. 3. Farr Institute, University of Manchester, Manchester, UK. 4. Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. 5. Research Applications and Data Management Team, IT Services, University of Aberdeen, Aberdeen, UK. 6. Academic Unit of Primary Medical Care, Northern General Hospital, Sheffield, UK. 7. Institute of Science and Technology in Medicine, University of Keele, Stoke-on-Trent, UK. 8. Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK. 9. Norwich Research Park Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich, UK.
Abstract
AIMS: This study was designed to evaluate whether survival rates in patients with heart failure (HF) are better than those in patients with diagnoses of the four most common cancers in men and women, respectively, in a contemporary primary care cohort in the community in Scotland. METHODS AND RESULTS: Data were obtained from the Primary Care Clinical Informatics Unit from a database of 1.75 million people registered with 393 general practices in Scotland. Sex-specific survival modelling was undertaken using Cox proportional hazards models, adjusted for potential confounders. A total of 56 658 subjects were eligible for inclusion in the study. These represented a total of 147 938 person-years of follow-up (median follow-up: 2.04 years). In men, HF (reference group; 5-year survival: 55.8%) had worse mortality outcomes than prostate cancer [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.57-0.65; 5-year survival: 68.3%], and bladder cancer (HR 0.88, 95% CI 0.81-0.96; 5-year survival: 57.3%), but better outcomes than lung cancer (HR 3.86, 95% CI 3.65-4.07; 5-year survival: 8.4%) and colorectal cancer (HR 1.23, 95% CI 1.16-1.31; 5-year survival: 48.9%). In women, HF (reference group; 5-year survival: 49.5%) had worse mortality outcomes than breast cancer (HR 0.55, 95% CI 0.51-0.59; 5-year survival 77.7%), but better outcomes than colorectal cancer (HR 1.21, 95% CI 1.13-1.29; 5-year survival 51.5%), lung cancer (HR 3.82, 95% CI 3.60-4.05; 5-year survival 10.4%), and ovarian cancer (HR 1.98, 95% CI 1.80-2.17; 5-year survival 38.2%). CONCLUSIONS: Despite advances in management, HF remains as 'malignant' as some of the common cancers in both men and women.
AIMS: This study was designed to evaluate whether survival rates in patients with heart failure (HF) are better than those in patients with diagnoses of the four most common cancers in men and women, respectively, in a contemporary primary care cohort in the community in Scotland. METHODS AND RESULTS: Data were obtained from the Primary Care Clinical Informatics Unit from a database of 1.75 million people registered with 393 general practices in Scotland. Sex-specific survival modelling was undertaken using Cox proportional hazards models, adjusted for potential confounders. A total of 56 658 subjects were eligible for inclusion in the study. These represented a total of 147 938 person-years of follow-up (median follow-up: 2.04 years). In men, HF (reference group; 5-year survival: 55.8%) had worse mortality outcomes than prostate cancer [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.57-0.65; 5-year survival: 68.3%], and bladder cancer (HR 0.88, 95% CI 0.81-0.96; 5-year survival: 57.3%), but better outcomes than lung cancer (HR 3.86, 95% CI 3.65-4.07; 5-year survival: 8.4%) and colorectal cancer (HR 1.23, 95% CI 1.16-1.31; 5-year survival: 48.9%). In women, HF (reference group; 5-year survival: 49.5%) had worse mortality outcomes than breast cancer (HR 0.55, 95% CI 0.51-0.59; 5-year survival 77.7%), but better outcomes than colorectal cancer (HR 1.21, 95% CI 1.13-1.29; 5-year survival 51.5%), lung cancer (HR 3.82, 95% CI 3.60-4.05; 5-year survival 10.4%), and ovarian cancer (HR 1.98, 95% CI 1.80-2.17; 5-year survival 38.2%). CONCLUSIONS: Despite advances in management, HF remains as 'malignant' as some of the common cancers in both men and women.
Authors: Hadi R Ali; Cole R Michel; Ying H Lin; Timothy A McKinsey; Mark Y Jeong; Amrut V Ambardekar; Joseph C Cleveland; Richard Reisdorph; Nichole Reisdorph; Kathleen C Woulfe; Kristofer S Fritz Journal: J Mol Cell Cardiol Date: 2019-12-10 Impact factor: 5.000
Authors: Mirela Tuzovic; Eric H Yang; RenÉ R Sevag Packard; Patricia A Ganz; Gregg C Fonarow; Boback Ziaeian Journal: J Card Fail Date: 2019-02-12 Impact factor: 5.712