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Studies suggest that patients with heart failure are more likely to get cancer, probably because heart failure might induce cancer through shared mechanisms like inflammation or hereditary factors. According to a new study published in the European Heart Journal, statin use is linked to a 16 per cent decreased incidence of cancer in people with heart failure compared to non-statin users. Statin use was also associated with a 26 per cent lower chance of dying from cancer over the same period.
The present observational study in Hong Kong, which includes over 87,000 participants, is the largest to date, and the authors believe their findings can be generalised to other communities. However, there has been limited research into the link between statin use and the risk of acquiring cancer and dying from it in individuals with heart failure.
The study discovered that the longer patients with heart failure took statins, the lower their risk of cancer became. After adjusting for factors that could affect the results, such as age, sex, smoking, alcohol consumption, and other health problems, patients who stayed on statins for four to six years saw an 18 per cent reduction in their risk and those who stayed on them for six or more years saw a 22 per cent reduction in risk.
Similarly, patients who took statins for four to six years and six or more years had a 33 per cent and 39 per cent lower chance of dying from cancer, respectively, than those who took them for three months to two years.
"Ten years after starting statins, deaths from cancer were 3.8% among heart failure patients taking statins and 5.2% among non-users a reduction in the absolute risk of death of 1.4%. The reduction in the absolute risk of developing cancer after six years on statins was 22% lower compared to those who received only between three months and two years of statins," said Dr Kai-Hang Yiu, from The University of Hong Kong, who led the study.
For the study, the researchers analysed data from 87,102 patients in Hong Kong who were admitted to hospital with heart failure between 2003 and 2015. Patients were tracked until they were diagnosed with cancer or died, whichever occurred first, or until the end of 2018.
Patients were excluded from the trial if they had a history of cancer or were diagnosed or died from it within 90 days of their first heart failure diagnosis, if they had HIV, or if they had taken statins for less than 90 days. There were 36,176 statin users and 50,926 statin non-users left to be studied.
During the follow-up, 3,863 patients (4.4%) died of cancer, with the most prevalent types of the disease being colon, stomach, lung, liver, and biliary (liver) system. The researchers also discovered that statin users had fewer deaths from any cause than non-users: after ten years, 60.5 per cent (21,886) of statin users had died compared to 78.8 per cent (40,130) of non-statin users, implying that statin use was associated with a 38 per cent reduction in deaths from any cause.
According to the researchers, improvements in heart failure treatment, which saw a two-fold rise in five-year survival rates from 29% to 60% between 1970 and 2009, have been offset by an increase in mortality from other causes, particularly cancer, among heart failure patients.
Dr Yiu said: "Heart failure is a growing disease globally and deaths due to other causes unrelated to the heart and blood vessels are of concern. Our findings should raise doctors' awareness of the increasing cancer incidence among heart failure patients and encourage them to pay extra attention to non-cardiovascular-related outcomes. Moreover, our study highlights the relationship between heart failure and cancer development and provides important information regarding the possibility of reducing cancer incidence and related deaths by using statins in these patients.
So there is a strong association between heart failure and cancer, which call for potential strategies to reduce the risk of cancer, such as screening for cancer in heart failure patients.
(with inputs from agencies)
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