Heart failure pharmacotherapy and cancer: pathways and pre-clinical/clinical evidence

Nabil V. Sayour, Ágnes M. Paál, Pietro Ameri, Wouter C. Meijers, Giorgio Minotti, Ioanna Andreadou, Antonella Lombardo, Massimiliano Camilli, Heinz Drexel, Erik Lerkevang Grove, Gheorghe Andrei Dan, Andreea Ivanescu, Anne Grete Semb, Gianluigi Savarese, Dobromir Dobrev, Filippo Crea, Juan Carlos Kaski, Rudolf A. de Boer, Péter Ferdinandy, Zoltán V. Varga*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

2 Citations (Scopus)
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Abstract

Heart failure (HF) patients have a significantly higher risk of new-onset cancer and cancer-associated mortality, compared to subjects free of HF. While both the prevention and treatment of new-onset HF in patients with cancer have been investigated extensively, less is known about the prevention and treatment of new-onset cancer in patients with HF, and whether and how guideline-directed medical therapy (GDMT) for HF should be modified when cancer is diagnosed in HF patients. The purpose of this review is to elaborate and discuss the effects of pillar HF pharmacotherapies, as well as digoxin and diuretics on cancer, and to identify areas for further research and novel therapeutic strategies. To this end, in this review, (i) proposed effects and mechanisms of action of guideline-directed HF drugs on cancer derived from pre-clinical data will be described, (ii) the evidence from both observational studies and randomized controlled trials on the effects of guideline-directed medical therapy on cancer incidence and cancer-related outcomes, as synthetized by meta-analyses will be reviewed, and (iii) considerations for future pre-clinical and clinical investigations will be provided.

Original languageEnglish
Pages (from-to)1224-1240
Number of pages17
JournalEuropean Heart Journal
Volume45
Issue number14
DOIs
Publication statusPublished - 7 Apr 2024

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