AIMS: Better management of heart failure (HF) over the past two decades has improved survival, mainly by reducing the incidence of death due to cardiovascular (CV) causes. Deaths due to non-CV causes, particularly cancer, may be increasing. This study explored the modes of death of consecutive patients who attended a HF clinic over 17 years. METHODS AND RESULTS: A total of 935 deaths were ascertained from 2002 to 2018 among 1876 patients (mean age 65.8 ± 12.5 years, 75% men, left ventricular ejection fraction < 50%) admitted to our HF clinic. Median follow-up was 4.2 years [1.9-7.8]. Mode of death was curated from patient health records and verified by the Catalan and Spanish health system databases. Trends for every mode of death were assessed by polynomial regression. Two trends were observed: a significant reduction in sudden death (P = 0.03) without changes in HF progression as mode of death (P = 0.26), and a significant increase in non-CV modes of death (P < 0.001). Non-CV deaths accounted for 17.4% of deaths in 2002 and 65.8% of deaths in 2018. A total 138 deaths were due to cancer (37% of non-CV deaths). A significant trend was observed towards a progressive increase in cancer deaths over time (P = 0.002). The main mode of cancer mortality was lung cancer. CONCLUSIONS: The modes of death in HF have shifted over the last two decades. Patients with HF die less due to sudden death and more due to non-CV causes, mainly cancer. Whether HF triggers cancer, or cancer develops in HF survivors, deserves further insight.
AIMS: Better management of heart failure (HF) over the past two decades has improved survival, mainly by reducing the incidence of death due to cardiovascular (CV) causes. Deaths due to non-CV causes, particularly cancer, may be increasing. This study explored the modes of death of consecutive patients who attended a HF clinic over 17 years. METHODS AND RESULTS: A total of 935 deaths were ascertained from 2002 to 2018 among 1876 patients (mean age 65.8 ± 12.5 years, 75% men, left ventricular ejection fraction < 50%) admitted to our HF clinic. Median follow-up was 4.2 years [1.9-7.8]. Mode of death was curated from patient health records and verified by the Catalan and Spanish health system databases. Trends for every mode of death were assessed by polynomial regression. Two trends were observed: a significant reduction in sudden death (P = 0.03) without changes in HF progression as mode of death (P = 0.26), and a significant increase in non-CV modes of death (P < 0.001). Non-CV deaths accounted for 17.4% of deaths in 2002 and 65.8% of deaths in 2018. A total 138 deaths were due to cancer (37% of non-CV deaths). A significant trend was observed towards a progressive increase in cancer deaths over time (P = 0.002). The main mode of cancer mortality was lung cancer. CONCLUSIONS: The modes of death in HF have shifted over the last two decades. Patients with HF die less due to sudden death and more due to non-CV causes, mainly cancer. Whether HF triggers cancer, or cancer develops in HF survivors, deserves further insight.
Authors: C Shi; H H van der Wal; H H W Silljé; M M Dokter; F van den Berg; L Huizinga; M Vriesema; J Post; S D Anker; J G Cleland; L L Ng; N J Samani; K Dickstein; F Zannad; C C Lang; P L van Haelst; J A Gietema; M Metra; P Ameri; M Canepa; D J van Veldhuisen; A A Voors; R A de Boer Journal: J Intern Med Date: 2020-05-05 Impact factor: 8.989
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Authors: Giacomo Tini; Edoardo Bertero; Alessio Signori; Maria Pia Sormani; Christoph Maack; Rudolf A De Boer; Marco Canepa; Pietro Ameri Journal: J Am Heart Assoc Date: 2020-08-31 Impact factor: 5.501
Authors: Edouard Gerbaud; Ambroise Bouchard de La Poterie; Thomas Baudinet; Michel Montaudon; Marie-Christine Beauvieux; Anne-Iris Lemaître; Laura Cetran; Benjamin Seguy; François Picard; Fritz-Line Vélayoudom; Alexandre Ouattara; Rémi Kabore; Pierre Coste; Pierre Domingues-Dos-Santos; Bogdan Catargi Journal: J Clin Med Date: 2022-03-11 Impact factor: 4.241
Authors: Johanna Mueller-Leisse; Johanna Brunn; Christos Zormpas; Stephan Hohmann; Henrike Aenne Katrin Hillmann; Jörg Eiringhaus; Johann Bauersachs; Christian Veltmann; David Duncker Journal: Sensors (Basel) Date: 2022-03-05 Impact factor: 3.576