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Heart failure (HF) is the most common and serious cardiovascular complication of cancer therapy. As succinctly stated in an editorial by Lyon, ‘Success in the diagnosis and treatment of many cancers has resulted in a growing population of people living either cured of cancer or with their cancer controlled as a chronic disease by long-term treatment. This success story in modern medicine has created a new problem with some survivors developing cardiovascular disease (CVD) as a result of their cancer treatment.’1
CVD outcomes in patients with HF induced by cancer therapy are addressed in this issue of Heart.2 Comparing 75 patients with HF induced by cancer therapy (anthracycline chemotherapy or chest irradiation) to 894 patients with HF due to other causes, cancer therapy patients were younger, had fewer CVD comorbidities and a higher left ventricular (LV) ejection fraction but more severe LV diastolic dysfunction. Global longitudinal strain and cardiopulmonary exercise testing results were similar in both patient groups. On multivariable Cox regression analysis, HF due to cancer therapy, compared with other HF patients, was associated with a higher risk of death (HR 2.64; 95% CI 1.53 to 4.55; p=0.001) and the composite endpoint of LV assistant device implantation, heart transplantation or all-cause mortality (HR 1.79; 95% CI 1.10 to 2.91; p=0.019) (figure 1).
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