Evidence map›Paper›PMID 39041459›Full record

ArticleESC heart failure2024

Use of heart failure medical therapy before and after a cancer diagnosis: A longitudinal study.

Chengsheng Ju, Wallis C Y Lau, Charlotte Manisty, Pinkie Chambers, Ruth Brauer, Martin D Forster, Isla S Mackenzie, Li Wei

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Chengsheng JuResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.ORCID 0000-0001-7860-6262
Wallis C Y LauResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Charlotte ManistyInstitute of Cardiovascular Science, University College London, London, UK.
Pinkie ChambersResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Ruth BrauerResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Martin D ForsterUCL Cancer Institute, University College London, London, UK.
Isla S MackenzieMEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
Li WeiResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.ORCID 0000-0001-8840-7267

Funding

British Oncology Pharmacy Association-Pharmacy Research UK BOPA_PRUK-2021-3-CJUCL Graduate Research Scholarship
6 · The paper itself

Abstract

aimsWe aim to evaluate change in the use of prognostic guideline-directed medical therapies (GDMTs) for heart failure (HF) before and after a cancer diagnosis as well as the matched non-cancer controls, including renin-angiotensin-system inhibitors (RASIs), beta-blockers, and mineralocorticoid receptor antagonists (MRAs). METHODS AND

resultsWe conducted a longitudinal study in patients with HF in the UK Clinical Practice Research Datalink between 2005 and 2021. We selected patients with probable HF with reduced ejection fraction (HFrEF) based on diagnostic and prescription records. We described the longitudinal trends in the use and dosing of GDMTs before and after receiving an incident cancer diagnosis. HF patients with cancer were matched with a 1:1 ratio to HF patients without cancer to investigate the association between cancer diagnosis and treatment adherence, persistence, initiation, and dose titration as odds ratios (ORs) with 95% confidence intervals (CIs) using multivariable logistic regression models. Of 8504 eligible HFrEF patients with incident cancer, 4890 were matched to controls without cancer. The mean age was 75.7 (±8.4) years and 73.9% were male. In the 12 months following a cancer diagnosis, patients experienced reductions in the use and dosing of GDMT. Compared with the non-cancer controls, patients with cancer had higher risks for poor adherence for all three medication classes (RASIs: OR = 1.51, 95% CI = 1.35-1.68; beta-blockers: OR = 1.22, 95% CI = 1.08-1.37; MRAs: OR = 1.31, 95% CI = 1.08-1.59) and poor persistence (RASIs: OR = 2.04, 95% CI = 1.75-2.37; beta-blockers: OR = 1.35, 95% CI = 1.12-1.63; MRAs: OR = 1.49, 95% CI = 1.16-1.93), and higher risks for dose down-titration for RASIs (OR = 1.69, 95% CI = 1.40-2.04) and beta-blockers (OR = 1.31, 95% CI = 1.05-1.62). Cancer diagnosis was not associated with treatment initiation or dose up-titration. Event rates for HF hospitalization and mortality were higher in patients with poor adherence or persistence to GDMTs.

conclusionsFollowing a cancer diagnosis, patients with HFrEF were more likely to have reduced use of GDMTs for HF.

Indexed as

Adrenergic beta-AntagonistsHeart FailureNeoplasmsAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsFemaleFollow-Up StudiesHumansLongitudinal StudiesMaleMineralocorticoid Receptor AntagonistsPrognosisRetrospective StudiesStroke VolumeUnited KingdomAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsMineralocorticoid Receptor AntagonistsCancerHeart failureLongitudinal studyPharmacological treatment

Identifiers

PMID39041459
PMCPMC11631296

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.