Patients with a history of breast cancer or lymphoma may be more than three times as likely to develop heart failure (HF), according to research that will be presented at ACC.18 in Orlando.

Carolyn Larsen, MD, et al., tracked HF cases in 900 breast cancer and lymphoma patients and in 1,550 people without cancer from 1985 to 2010. Results showed that for every 100 cancer patients, about seven developed HF during the 8.5-year follow-up period. Patients with breast cancer or lymphoma were three times as likely to develop HF within five years of their cancer diagnosis. In addition, the cancer patients were nearly twice as likely to have a HF diagnosis 20 years after undergoing cancer treatment compared with patients who never had cancer.

The elevated risk of HF appeared as early as one year after a cancer diagnosis and persisted 20 years after patients completed cancer therapy. Some cancer patients had a higher likelihood than others of experiencing HF diagnosis. For example, when controlling for multiple heart disease risk factors, cancer patients who had diabetes or received higher doses of the chemotherapy drug doxorubicin were more than twice as likely to be diagnosed with HF.

According to the researchers, further investigation is needed to determine why diabetes carries a greater risk in cancer patients than other traditional risk factors, such as high blood pressure. Larsen adds that the findings raise questions about appropriate monitoring for heart problems in patients who have had cancer treatment and suggests that more frequent cardiac imaging may be warranted in some patients to detect early signs of HF.

“Cancer patients need to have good primary care and cardiology follow-up to make sure all of their risk factors for heart disease are optimally controlled,” said Larsen. “They should also be assessed for signs and symptoms of HF every year so that they can be diagnosed and started on appropriate medical treatment early on.”

Keywords: ACC18, ACC Annual Scientific Session, Risk Factors, Follow-Up Studies, Diabetes Mellitus, Heart Failure, Doxorubicin, Lymphoma, Hypertension, Breast Neoplasms, Primary Health Care

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