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Guideline-Directed Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Incident Cancer
Giacomo Tini1, Silvia Tanda2, Matteo Toma3
1Cardiology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Azienda Ospedaliera Universitaria Sant'Andrea, Rome, Italy.
Heart, Lung & Circulation
|April 12, 2024
Summary
Cancer diagnosis may require temporary heart failure medication adjustments. However, guideline-directed medical therapy (GDMT) for heart failure (HF) is generally maintained during cancer follow-up.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Cancer may impede guideline-directed medical therapy (GDMT) for heart failure (HF).
- Limited data exist on the impact of cancer on HF treatment delivery.
Purpose of the Study:
- To investigate whether incidental cancer affects the delivery of GDMT in heart failure patients.
- To compare GDMT prescription in HF patients with and without cancer.
- To analyze changes in GDMT before and after cancer diagnosis.
Main Methods:
- Retrospective analysis of 464 HF patients (left ventricular ejection fraction <50%) from 2010-2019.
- Assessed prescription of beta-blockers (BB), RAS inhibitors (RASi), and MRA.
- Compared GDMT between HF patients with and without incidental cancer and analyzed changes post-cancer diagnosis.
Main Results:
- 8% of HF patients (39/464) had incidental cancer.
- No significant differences in overall GDMT at last evaluation between groups.
- In the year post-cancer diagnosis, some patients required BB, RASi, or MRA dose reduction or discontinuation.
Conclusions:
- Incidental cancer may necessitate temporary down-titration of GDMT in HF patients.
- Cancer diagnosis does not appear to significantly hinder long-term HF therapy delivery.
- Continued monitoring and management of HF therapies are crucial in cancer patients.
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