title: Heart failure following cancer treatment: characteristics, survival and mortality of a linked health data analysis.
abstract: BACKGROUND
  Cardiotoxicity resulting in heart failure is a devastating complication of cancer therapy. A patient may survive cancer only to develop heart failure (HF), which has a higher mortality rate than some cancers.
  
  
  OBJECTIVE
  This study aimed to describe the characteristics and outcomes of HF in patients with blood or breast cancer after chemotherapy treatment.
  
  
  METHODS
  Queensland Cancer Registry, Death Registry and Hospital Administration records were linked (1996-2009). Patients were categorised as those with an index HF admission (that occurred after cancer diagnosis) and those without an index HF admission (non-HF).
  
  
  RESULTS
  A total of 15 987 patients was included, and 1062 (6.6%) had an index HF admission. Median age of HF patients was 67 years (interquartile range 58-75) versus 54 years (interquartile range 44-64) for non-HF patients. More men than women developed HF (48.6% vs 29.5%), and a greater proportion in the HF group had haematological cancer (83.1%) compared with breast cancer (16.9%). After covariate adjustment, HF patients had increased mortality risk compared with non-HF patients (hazard ratios 1.67 (95% confidence interval, 1.54-1.81)), and 47% of the index HF admission occurred within 1 year from cancer diagnosis and 70% within 3 years.
  
  
  CONCLUSIONS
  Cancer treatment may place patients at a greater risk of developing HF. The onset of HF occurred soon after chemotherapy, and those who developed HF had a greater mortality risk.
authors: School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia. robyn.clark@flinders.edu.au.
authors: R A
authors: RA
authors: Clark
authors: School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.
authors: N M
authors: NM
authors: Berry
authors: School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.
authors: M H
authors: MH
authors: Chowdhury
authors: School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
authors: A L
authors: AL
authors: McCarthy
authors: Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia.
authors: S
authors: S
authors: Ullah
authors: Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Victoria, Australia.
authors: V L
authors: VL
authors: Versace
authors: Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors: J J
authors: JJ
authors: Atherton
authors: Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia.
authors: B
authors: B
authors: Koczwara
authors: School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors: D
authors: D
authors: Roder
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D011793:Queensland; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
keywords: cardiology; cardiotoxicity; chemotherapy; heart failure; oncology