After enhancing the survivorship of cancers, the impact of cardiovascular diseases
on mortality is increasing among cancer patients. However, anticancer therapies pose
a higher cardiovascular risk to patients. As prevention against cancer therapy-induced
cardiomyopathy has yet to be explored, the preventive ability of concomitant cardiovascular
medications against incident heart failure was assessed.A retrospective, population-based
study was run using anonymized integration of healthcare databases. All the Hungarian
patients diagnosed with breast or colorectal carcinoma and undergoing chemotherapy
or biological therapy were analysed. Participants were not treated with any anticancer
therapy nor suffered from heart failure/dilated cardiomyopathy during the preceding
observational period (≥6.5 years). The heart failure endpoint was established by I50
International Classification of Diseases codes upon discharge from hospital or issuance
of an autopsy report.Among the 9575 patients who were enrolled, the cumulative incidence
of heart failure over 4 years was 6.9%. The time until the first heart failure event
in the propensity score-matched treated and untreated groups was compared using Cox
proportional-hazards models. A significant association between lower heart failure
risk and concomitant statin therapy was observed (hazard ratio: 0.748, P = 0.038);
the preventive ability was more pronounced in the anthracycline/capecitabine/platinum-treated
subgroup (hazard ratio: 0.660, P = 0.032). For angiotensin-converting enzyme inhibitor/angiotensin
II receptor blocker therapy, a significantly lower heart failure risk was also observed
(hazard ratio: 0.809, P = 0.032). Among beta blockers, nebivolol administered to anthracycline/capecitabine-treated
patients was associated with a nonsignificant trend to lower heart failure risk (hazard
ratio: 0.584, P = 0.069).Only concomitant statin and angiotensin-converting enzyme
inhibitor/angiotensin II receptor blocker therapies were associated with significantly
lower risk of anticancer therapy-related heart failure.
