People with diabetes and cancer have a 2.19-fold higher heart failure risk than those with diabetes alone, with an annual HF incidence of 1.08%.
Does a concurrent cancer diagnosis increase the risk of incident heart failure in patients with diabetes mellitus?
A concurrent cancer diagnosis more than doubles the risk of incident heart failure in patients aged 50 and older with diabetes mellitus, though the absolute annual risk remains around 1%.
Absolute Event Rate: 0% vs 0%
Abstract Background Heart failure (HF) screening in all cancer survivors is currently not justified due to insufficient risk. However, people with diabetes mellitus (DM) have an increased risk of both HF and cancer, and may represent a population at sufficient risk to justify screening. Objectives To examine the incidence of HF in people with DM and cancer compared to DM alone. Methods A registry was created by linking the Australian National Diabetes Services Scheme (NDSS; 792,757 DM, types 1 and 2) from 2010 to 2022, with public hospital data, the National Death Index and national Pharmaceutical Benefits Scheme (PBS) database. People with cancer were identified by the prescription of chemotherapy agents on the PBS dataset or a hospital admission with cancer. Incident HF was defined as first hospitalisation with HF as the primary diagnosis or death due to HF. The model was adjusted for age, sex, therapy with statins, calcium channel blockers and renin-angiotensin-aldosterone system (RAAS) medications. Results Over a 12-year period (2010-2022), 792,757 people aged 50 years or older with DM were registered with the NDSS. There were 31,082 people who experienced HF during 6,295,739 person years of follow up (average 0.49% per year). Specifically, of 143,111 people with DM and cancer, 5532 experienced HF during 514,525 person years of follow up (average 1.08% per year). Incidence rate ratio (IRR) of heart failure of people with DM and cancer was 2.19 95% CI 2.12-2.25, compared to people with DM but no cancer. Cancer admission alone had an IRR of 1.46 95% CI 1.39-1.54 compared to those treated with chemotherapy. Conclusions People with DM and cancer have an increased incidence of HF compared with DM alone. A cancer diagnosis without prescription of chemotherapy has a higher IRR than those who received chemotherapy, suggesting that cancer itself may contribute to HF risk. However, the 1% annual incidence rate is on its own is likely insufficient to justify screening and further risk stratification is required.
Wong et al. (Sat,) reported a other. People with diabetes and cancer have a 2.19-fold higher heart failure risk than those with diabetes alone, with an annual HF incidence of 1.08%.