Key result
Chemotherapy in HF patients is linked to ~26% higher readmission risk.
Why the study?
Cardio-oncology has received increasing attention due to the cardiotoxic effects of anti-cancer therapies, requiring evaluation of clinical characteristics and outcomes in patients with HF receiving chemotherapy.
Does chemotherapy increase the risk of readmission in patients with heart failure?
Observational (n=11,532)
Yes
Does chemotherapy increase the risk of readmission in patients with heart failure?
In patients with heart failure, receiving chemotherapy (especially EGFR-TKIs, taxanes, anthracyclines, and fluorouracil) is associated with a significantly higher risk of readmission compared to matched HF patients not receiving chemotherapy.
Chemotherapy may raise HF readmission risk; hypothesis-generating and should not yet change practice.
BACKGROUND: The optimal strategy for modern chemotherapy should be based on a comprehensive approach for cancer patients with cardiovascular diseases. Therefore, cardio-oncology has received increasing attention owing to the cardiotoxic effects of anti-cancer therapies. OBJECTIVES: We aimed to evaluate the clinical characteristics and outcomes of patients with heart failure (HF) who received chemotherapy compared with those of a matched cohort with HF who did not receive chemotherapy, using real-world HF data. METHODS: This study was based on the Diagnosis Procedure Combination (DPC) database of the Japanese Registry of All Cardiac and Vascular Diseases (JROAD). We identified 1 328 113 patients who were hospitalized for HF between April 2012 and March 2021. The propensity score (PS) was estimated using a logistic regression model, with chemotherapy as the dependent variable, and a clinically score-matched analysis of 11 532 patients with HF with or without chemotherapy. The primary endpoint was readmission. RESULTS: Colon, lung, breast and prostate cancers accounted for >60% of all cancer types. After PS matching, readmission was significantly more frequently observed in patients with chemotherapy than those without [odds ratio (OR), 1.26; 95% confidence interval (CI) 1.17-1.36, P < 0.01]. In particular, treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) (OR, 1.69; 95% CI 1.39-2.07), taxane (OR, 2.95; 95% CI 2.11-4.12), anthracyclines (OR, 1.86; 95% CI 1.19-2.90) and fluorouracil agents (OR, 1.65; 95% CI 1.18-2.30) caused a higher risk of readmission. CONCLUSIONS: Medical providers need to monitor and follow-up patients with HF, depending on the characteristics of the anti-cancer agents and types of cancer.
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Sunaga et al. (2025) conducted an observational in Heart failure and cancer (n=11,532). Chemotherapy vs. No chemotherapy was evaluated on Readmission (OR 1.26, 95% CI 1.17-1.36, p=< 0.01). Chemotherapy in patients with heart failure was associated with a significantly higher risk of readmission compared to those without chemotherapy (OR 1.26; 95% CI 1.17-1.36; P<0.01).
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