Table 2.
Propensity-weighted difference (95% confidence interval) in primary outcomes and discharge medication for patients with heart failure admission by cancer diagnosis and tumour site
| Outcome | Propensity-weighted | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total | Cancer | Tumour site | ||||||||||||||
| Yes | No | Diff (95% CI) | Breast cancer | Prostate cancer | Colorectal cancer | Lung cancer | ||||||||||
| Yes | No | Diff (95% CI) | Yes | No | Diff (95% CI) | Yes | No | Diff (95% CI) | Yes | No | Diff (95% CI) | |||||
| Number of patients | 221 953 | 12 867 | 209 086 | 3216 | 97 768 | 5118 | 111 318 | 3199 | 209 086 | 1334 | 209 086 | |||||
| HF hospital admission | ||||||||||||||||
| Main place of care | ||||||||||||||||
| Other | 123 521 (55.7%) | 59.7% | 57.2% | 2.5 (1.6, 3.3) | 62.4% | 61.5% | 0.9 (−0.8, 2.6) | 56.5% | 54.2% | 2.3 (0.9, 3.7) | 59.4% | 58.1% | 1.4 (−0.4, 3.1) | 66.0% | 55.9% | 10.1 (7.5, 12.6) |
| Cardiology | 97 592 (44.0%) | 40.0% | 42.4% | −2.4 (−3.3, −1.6) | 37.2% | 38.1% | −0.9 (−2.6, 0.8) | 43.2% | 45.4% | −2.2 (−3.6, −0.8) | 40.2% | 41.6% | −1.3 (−3.0, 0.4) | 33.7% | 43.7% | −10.1 (−12.6, −7.5) |
| Unknown | 840 (0.4%) | 0.3% | 0.4% | 0.0 (−0.1, 0.1) | 0.4% | 0.4% | 0.0 (−0.2, 0.2) | 0.3% | 0.4% | −0.1 (−0.2, 0.1) | 0.3% | 0.4% | 0.0 (−0.2, 0.2) | 0.4% | 0.4% | 0.0 (−0.3, 0.3) |
| Died in the hospital | ||||||||||||||||
| No | 211 249 (95.2%) | 94.2% | 94.9% | −0.7 (−1.1, −0.3) | 94.7% | 95.2% | −0.5 (−1.3, 0.3) | 94.1% | 94.6% | −0.5 (−1.2, 0.2) | 94.2% | 94.6% | −0.4 (−1.2, 0.4) | 93.0% | 95.4% | −2.4 (−3.8, −1.0) |
| Yes | 10 704 (4.8%) | 5.9% | 5.0% | 0.7 (0.3, 1.1) | 5.3% | 4.8% | 0.5 (−0.3, 1.3) | 5.9% | 5.4% | 0.5 (−0.2, 1.2) | 5.8% | 5.4% | 0.4 (−0.4, 1.2) | 7.0% | 4.6% | 2.4 (1.0, 3.8) |
| HF presentation | ||||||||||||||||
| HFrEF, n (%) | ||||||||||||||||
| No | 97 927 (44.1%) | 45.4% | 44.7% | 0.6 (−0.3, 1.5) | 53.3% | 53.9% | −0.5 (−2.3, 1.2) | 39.9% | 38.8% | 1.1 (−0.3, 2.5) | 45.2% | 45.2% | 0.0 (−1.8, 1.7) | 47.6% | 43.7% | 3.9 (1.2, 6.6) |
| Yes | 119 446 (53.8%) | 52.5% | 53.2% | −0.8 (−1.7, 0.1) | 44.1% | 43.9% | 0.1 (−1.6, 1.9) | 58.0% | 59.2% | −1.2 (−2.6, 0.1) | 53.0% | 52.8% | 0.3 (−1.5, 2.0) | 50.0% | 54.3% | −4.3 (−7.0, −1.6) |
| Unknown | 4580 (2.1%) | 2.2% | 2.0% | 0.1 (−0.1, 0.4) | 2.6% | 2.2% | 0.4 (−0.2, 0.9) | 2.1% | 2.0% | 0.1 (−0.3, 0.5) | 1.8% | 2.0% | −0.3 (−0.7, 0.2) | 2.4% | 1.9% | 0.5 (−0.4, 1.3) |
| NYHA Classification, n (%) | ||||||||||||||||
| 1 | 13 904 (6.3%) | 5.9% | 6.2% | −0.3 (−0.7, 0.1) | 5.5% | 6.2% | −0.7 (−1.5, 0.1) | 6.5% | 6.4% | 0.2 (−0.5, 0.9) | 5.9% | 6.2% | −0.3 (−1.1, 0.5) | 4.7% | 5.6% | −0.9 (−2.1, 0.2) |
| 2 | 31 697 (14.3%) | 13.6% | 14.1% | −0.5 (−1.1, 0.1) | 13.4% | 14.3% | −0.9 (−2.1, 0.3) | 14.2% | 14.0% | 0.2 (−0.8, 1.2) | 13.7% | 14.0% | −0.4 (−1.6, 0.8) | 11.8% | 13.7% | −1.9 (−3.6, −0.1) |
| 3 | 90 471 (40.8%) | 40.9% | 41.0% | −0.1 (−1.0, 0.8) | 40.9% | 40.6% | 0.3 (−1.4, 2.0) | 41.3% | 41.3% | 0.0 (−1.4, 1.4) | 39.5% | 41.0% | −1.4 (−3.1, 0.3) | 42.7% | 41.6% | 1.1 (−1.5, 3.8) |
| 4 | 71 043 (32.0%) | 33.2% | 32.2% | 1.0 (0.2, 1.9) | 33.6% | 32.3% | 1.3 (−0.3, 3.0) | 31.9% | 31.9% | 0.0 (−1.3, 1.3) | 34.4% | 32.3% | 2.0 (0.4, 3.7) | 34.5% | 33.0% | 1.5 (−1.1, 4.0) |
| Unknown | 14 838 (6.7%) | 6.3% | 6.5% | −0.2 (−0.6, 0.3) | 6.6% | 6.7% | −0.1 (−1.0, 0.8) | 6.1% | 6.4% | −0.4 (−1.0, 0.3) | 6.5% | 6.5% | 0.0 (−0.8, 0.9) | 6.2% | 6.0% | 0.2 (−1.1, 1.5) |
| Discharge medication a | ||||||||||||||||
| Number of patients with HFrEF and did not die in the hospital | 114 001 | 6385 | 107 616 | — | 1355 | 40 913 | — | 2794 | 66 703 | — | 1604 | 107 616 | — | 632 | 107 616 | — |
| ACEi/ARB | ||||||||||||||||
| No | 28 341 (24.9%) | 28.4% | 26.7% | 1.7 (0.6, 2.9) | 25.5% | 26.3% | −0.8 (−3.2, 1.6) | 28.8% | 27.3% | 1.6 (−0.1, 3.3) | 30.0% | 27.7% | 2.3 (0.1, 4.6) | 29.1% | 25.1% | 4.1 (0.5, 7.6) |
| Yes | 78 037 (68.5%) | 64.1% | 66.2% | −2.1 (−3.3, −0.9) | 67.6% | 66.9% | 0.7 (−1.8, 3.2) | 63.8% | 65.4% | −1.7 (−3.5, 0.2) | 62.3% | 65.0% | −2.7 (−5.1, −0.3) | 62.5% | 68.4% | −5.9 (−9.7, −2.1) |
| Unknown/NA | 7623 (6.7%) | 7.5% | 7.1% | 0.4 (−0.3, 1.1) | 6.9% | 6.8% | 0.1 (−1.3, 1.5) | 7.4% | 7.3% | 0.1 (−0.9, 1.1) | 7.7% | 7.3% | 0.4 (−0.9, 1.7) | 8.4% | 6.6% | 1.8 (−0.3, 4.0) |
| Beta-blocker | ||||||||||||||||
| No | 22 044 (19.3%) | 21.0% | 20.6% | 0.4 (−0.7, 1.4) | 19.9% | 20.3% | −0.4 (−2.5, 1.8) | 20.8% | 21.1% | −0.2 (−1.8, 1.3) | 20.9% | 21.0% | −0.2 (−2.2, 1.9) | 24.1% | 20.9% | 3.1 (−0.2, 6.5) |
| Yes | 84 052 (73.7%) | 71.5% | 72.0% | −0.6 (−1.7, 0.6) | 73.3% | 72.6% | 0.7 (−1.7, 3.1) | 71.7% | 71.3% | 0.4 (−1.3, 2.1) | 71.1% | 71.4% | −0.3 (−2.5, 2.0) | 67.4% | 72.1% | −4.7 (−8.4, −1.1) |
| Unknown/NA | 7905 (6.9%) | 7.6% | 7.4% | 0.2 (−0.5, 0.9) | 6.8% | 7.1% | −0.3 (−1.7, 1.1) | 7.5% | 7.6% | −0.2 (−1.2, 0.8) | 8.0% | 7.6% | 0.4 (−0.9, 1.8) | 8.5% | 6.9% | 1.6 (−0.5, 3.8) |
| Loop diuretic | ||||||||||||||||
| No | 12 507 (11.0%) | 10.9% | 10.2% | 0.6 (−0.2, 1.4) | 10.7% | 10.8% | −0.1 (−1.8, 1.5) | 10.4% | 10.0% | 0.4 (−0.8, 1.6) | 10.8% | 10.0% | 0.8 (−0.8, 2.3) | 13.3% | 10.3% | 2.9 (0.3, 5.6) |
| Yes | 93 848 (82.3%) | 82.4% | 83.0% | −0.6 (−1.6, 0.3) | 83.0% | 82.7% | 0.2 (−1.8, 2.3) | 82.9% | 83.0% | −0.2 (−1.6, 1.3) | 82.5% | 83.2% | −0.7 (−2.5, 1.2) | 79.0% | 83.2% | −4.3 (−7.4, −1.1) |
| Unknown/NA | 7646 (6.7%) | 6.8% | 6.7% | 0.0 (−0.6, 0.6) | 6.3% | 6.4% | −0.1 (−1.4, 1.2) | 6.7% | 7.0% | −0.2 (−1.2, 0.7) | 6.7% | 6.8% | −0.1 (−1.3, 1.1) | 7.8% | 6.4% | 1.3 (−0.8, 3.4) |
| MRA | ||||||||||||||||
| No | 51 823 (45.5%) | 48.1% | 46.9% | 1.2 (−0.1, 2.5) | 48.0% | 48.3% | −0.3 (−3.0, 2.4) | 47.0% | 46.6% | 0.4 (−1.5, 2.3) | 49.0% | 47.6% | 1.4 (−1.1, 3.8) | 50.6% | 45.4% | 5.2 (1.3, 9.2) |
| Yes | 45 363 (39.8%) | 36.1% | 37.8% | −1.7 (−2.9, −0.5) | 36.5% | 36.0% | 0.5 (−2.1, 3.1) | 37.6% | 38.1% | −0.5 (−2.4, 1.3) | 34.9% | 36.8% | −1.9 (−4.3, 0.4) | 32.3% | 39.8% | −7.6 (−11.2, −3.9) |
| Unknown/NA | 16 815 (14.7%) | 15.8% | 15.3% | 0.5 (−0.4, 1.4) | 15.5% | 15.7% | −0.2 (−2.2, 1.7) | 15.4% | 15.3% | 0.2 (−1.2, 1.5) | 16.1% | 15.6% | 0.6 (−1.3, 2.4) | 17.1% | 14.8% | 2.3 (−0.6, 5.3) |
| Digoxin | ||||||||||||||||
| No | 70 564 (61.9%) | 61.1% | 61.4% | −0.4 (−1.6, 0.9) | 60.6% | 60.8% | −0.2 (−2.8, 2.5) | 61.8% | 62.1% | −0.3 (−2.1, 1.6) | 61.0% | 61.6% | −0.6 (−3.0, 1.8) | 59.0% | 60.8% | −1.8 (−5.6, 2.1) |
| Yes | 17 998 (15.8%) | 16.3% | 16.1% | 0.2 (−0.8, 1.1) | 18.5% | 17.2% | 1.3 (−0.8, 3.4) | 15.1% | 15.1% | 0.0 (−1.3, 1.4) | 16.7% | 15.9% | 0.8 (−1.0, 2.6) | 16.0% | 16.9% | −0.9 (−3.8, 2.0) |
| Unknown/NA | 25 439 (22.3%) | 22.6% | 22.4% | 0.2 (−0.9, 1.3) | 21.0% | 22.0% | −1.1 (−3.3, 1.1) | 23.0% | 22.8% | 0.3 (−1.3, 1.9) | 22.3% | 22.5% | −0.2 (−2.3, 1.9) | 25.0% | 22.4% | 2.6 (−0.8, 6.0) |
HF, heart failure; HFrEF, heart failure with reduced ejection fraction; NYHA, New York Heart Association; ACEi/ARB, angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists; MRA, mineralocorticoid receptor antagonists; Diff, difference. Lung cancer includes trachea, bronchus, and lung cancers. The no breast cancer group includes females only, whilst the no prostate cancer group includes males only.
Propensity score includes the variables: age at HF admission, sex, ethnicity year of HF admission, ischaemic heart disease, valve disease, diabetes, and chronic obstructive pulmonary disease.
Discharge medication was evaluated for patients who did not die in the hospital and had left ventricular systolic dysfunction.