Common risk factors for heart failure and cancer

Abstract

Cardiovascular (CV) disease and cancer are the leading causes of death. 1 , 2 Over the last decades, it has been appreciated that both CV disease and cancer are more common in individuals in whom risk factors for disease development accumulate, and preventative measures have been extremely important in driving down the incidence of disease. 3–6 In general, the field of epidemiology, risk reduction, and preventative trials is divided into health care professionals who have an interest in either CV disease or cancer. As a result, the medical literature and medical practice has largely focused on the one disease, or the other. However, human individuals do not behave according to this dogma. Emerging data clearly suggest that identical risk factors may lead to CV disease in the one individual, but may cause cancer in another, or even both diseases in the same individual. This overlap exists between risk factors that are historically classified as ‘CV risk factors’ as these factors do equally strong predict cancer development. Therefore, we propose that a holistic approach might better estimate actual risks for CV disease and cancer. In this review, we summarize current insights in common behavioural risk factors for heart failure, being the most progressed and lethal form of CV disease, and cancer.

Recent advances in cardio‐oncology: a report from the ‘Heart Failure Association 2019 and World Congress on Acute Heart Failure 2019’

“…24,48 A recent 10year follow-up study with 350 breast cancer survivors previously treated with chemotherapy and/or radiation therapy compared with 350 age-matched healthy women demonstrated an increased risk of mild left ventricular (LV) dysfunction in cancer survivors (15.3% vs. 7%). [50][51][52] In the CANTOS trial, 53 which included 10 061 patients with myocardial infarction and increased high-sensitive C-reactive protein, the inhibition of the cytokine interleukin 1β with canakinumab (patients randomized to 50, 150, and 300 mg, or placebo) showed a reduction of nonfatal myocardial infarction, nonfatal stroke, or CV death with 150 mg canakinumab. 23 The intersection between HF and cancer was explored by Associate Professor Farmakis and Professor Denise Hilfiker-Kleiner (Hannover, Germany).…”

“…Both entities share several risk factors (ageing, tobacco, adiposity, physical inactivity, and infections) and an underlying systemic inflammatory status. [50][51][52] In the CANTOS trial, 53 which included 10 061 patients with myocardial infarction and increased high-sensitive C-reactive protein, the inhibition of the cytokine interleukin 1β with canakinumab (patients randomized to 50, 150, and 300 mg, or placebo) showed a reduction of nonfatal myocardial infarction, nonfatal stroke, or CV death with 150 mg canakinumab. 54 A secondary analysis of the data by Ridker et al 55 showed a reduction of lung cancer incidence (with 150 and 300 mg canakinumab vs. placebo) and lung cancer mortality (with 300 mg of canakinumab vs. placebo).…”

Strategies to prevent anthracycline-induced cardiotoxicity in cancer survivors

“…Cardiovascular disease in general, and HF in particular, appear strongly related to cancer [8]. They share classical risk factors, including smoking, sedentary lifestyle, and obesity.…”

Troponins and natriuretic peptides to detect cardiotoxicity: useful biomarkers or paradise lost?

“…infections, dehydration, kidney failure, and anaemia are more frequently observed. 16 Lastly, with regard to preventive therapy, the authors show that treatment with beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers significantly reduced cTn levels in patients treated with anthracyclines (OR 4.1). It has previously been suggested that preventive heart failure treatment diminishes the cardiotoxic effects of anthracycline and trastuzumab.…”

“…In patients with cancer, this most likely weighs in even more, as e.g. infections, dehydration, kidney failure, and anaemia are more frequently observed …”