Versace Vincent L, Berry Narelle M, Chowdhury Munir H, Ullah Shahid, McCarthy Alexandra L, Atherton John J, Koczwara Bogda, Roder David, Clark Robyn A
School of Medicine Deakin University Warrnambool VIC 3280 Australia.
School of Nursing and Midwifery Flinders University Adelaide SA Australia.
ESC Heart Fail. 2016 Dec;3(4):253-260. doi: 10.1002/ehf2.12099. Epub 2016 Jul 17.
To describe the characteristics and time to death of patients with breast or haematological cancer who died of heart failure (HF) after cancer therapy. Patients with an index admission for HF who died of HF-related causes (IAHF) and those with no index admission for HF who died of HF-related causes (NIAHF) were compared.
We performed a linked data analysis of cancer registry, death registry, and hospital administration records ( = 15 987). Index HF admission must have occurred after cancer diagnosis. Of the 4894 patients who were deceased (30.6% of cohort), 734 died of HF-related causes (50.1% female) of which 279 (38.0%) had at least one IAHF (41.9% female) post-cancer diagnosis. Median age was 71 years [interquartile range (IQR) 62-78] for IAHF and 66 years (IQR 56-74) for NIAHF. There were fewer chemotherapy separations for IAHF patients (median = 4, IQR 2-9) compared with NIAHF patients (median = 6, IQR 2-12). Of the IAHF patients, 71% had died within 1 year of the index HF admission. There was no significant difference in HF-related mortality in IAHF patients compared with NIAHF (HR, 1.10, 95% CI, 0.94-1.29, = 0.225).
The profile of IAHF patients who died of HF-related causes after cancer treatment matched the current profile of HF in the general population (over half were aged ≥70 years). However, NIAHF were younger (62% were aged ≤69 years), female patients with breast cancer that died of HF-related causes before hospital admission for HF-related causes-a group that may have been undiagnosed or undertreated until death.
描述癌症治疗后死于心力衰竭（HF）的乳腺癌或血液系统癌症患者的特征及死亡时间。比较因HF相关原因死亡且首次因HF入院的患者（IAHF）和未因HF首次入院但因HF相关原因死亡的患者（NIAHF）。
我们对癌症登记、死亡登记和医院管理记录进行了关联数据分析（n = 15987）。首次HF入院必须发生在癌症诊断之后。在4894例死亡患者（占队列的30.6%）中，734例死于HF相关原因（50.1%为女性），其中279例（38.0%）在癌症诊断后至少有一次IAHF（41.9%为女性）。IAHF患者的中位年龄为71岁[四分位间距（IQR）62 - 78]，NIAHF患者为66岁（IQR 56 - 74）。与NIAHF患者（中位值 = 6，IQR 2 - 12）相比，IAHF患者的化疗间隔较少（中位值 = 4，IQR 2 - 9）。在IAHF患者中，71%在首次HF入院后1年内死亡。IAHF患者与NIAHF患者的HF相关死亡率无显著差异（HR，1.10，95%CI，0.94 - 1.29，P = 0.225）。
癌症治疗后死于HF相关原因的IAHF患者特征与普通人群当前的HF特征相符（超过一半年龄≥70岁）。然而，NIAHF患者较年轻（62%年龄≤69岁），是在因HF相关原因入院前死于HF相关原因的乳腺癌女性患者——这一群体在死亡前可能未被诊断或治疗不足。
