[en] Objectives: During the last years publications have emerged suggesting heart failure (HF) might be an independent risk factor of cancer. Nevertheless, evidence published is for the time being weak. Therefore, the main endpoint of this study is to assess in patients with HF the incidence of the new diagnosis of malignancy, to analyse the major risk factors associated to the development of neoplasms, and to determinate its mortality and prognosis, comparing these outcomes with those related to the general population. As secondary endpoint, we analyse in addition the prognosis of HF in patients with a previous history of malignancy. Methods: We conducted an observational and single-center study based in a prospective cohort of patients with HF referred to the Advanced Heart Failure Unit of the Cardiology Service of A Coruña Universitary Hospital Complex, in Spain, since its creation in 2010 until 2019. Non-melanoma skin cancer was specifically excluded from the definition of newly diagnosed malignancies, with the purpose to compare our results with those estimated for the general Spanish population according to the Global Cancer Observatory. [Results] During follow-up of 1909 consecutive patients with HF over a median time of 4.07 years, 165 new cases of malignancy were diagnosed. Observed age-standardized incidence rates of cancer per 100,000 persons-years were 861 cases (95% Confidence Interval (CI) 618.4–2,159.4) in men and 728.5 cases (95% CI 451.1–4,308.7) in women in the HF group; while age-standardized incidence rates of cancer expected for the general Spanish population per 100,000 persons-years were 479.4 cases in men (risk ratio = 1.80) and 295.5 cases in women (risk ratio = 2.46). Both a history of pre-existing malignancy at baseline and the development of new malignancies during follow-up were associated with reduced survival. Observed age-standardized cancer-related mortality rates per 100,000 persons-years were 344.1 deaths (95% CI 202.1–1675) in men and 217 deaths (95% CI 32.8–3949.3) in women in the HF population; while age-standardized cancer-related mortality rates per 100,000 persons-years expected for the general Spanish population were 201.4 deaths in men (risk ratio = 1.71) and 96.2 deaths per 100,000 persons-years in women (risk ratio = 2.26). Conclusions: Patients with HF showed higher incidence rates of cancer diagnosis and cancer-related mortality than those expected for the general population, both in women and in men, being the survival after a new diagnosis of malignancy poor.

[gl] Obxectivos: Nos últimos anos xurdiron publicacións que suxiren que a insuficiencia cardíaca (IC) podería ser un factor de risco independente de cancro. Non obstante, a evidencia publicada é polo momento feble. O obxectivo principal deste estudo é analizar en pacientes con IC a incidencia de nova neoplasia no seguimento, coñecer os principais factores de risco asociados ó desenvolvemento de cancro e determinar o seu prognóstico, comparando estes resultados cos da poboación xeral. Como obxectivo secundario, analizamos o prognóstico da IC no paciente con antecedente de neoplasia. Métodos: Tratase dun estudo observacional unicéntrico, baseado nunha cohorte histórica prospectiva de pacientes con IC remitidos á Unidade de IC Avanzada do Servizo de Cardioloxía do Complexo Hospitalario Universitario da Coruña, en España, desde a súa creación en 2010 ata 2019. O cancro de pel non-melanoma foi especificamente excluído da definición de malignidade, para poder comparar os nosos resultados cos estimados para a poboación xeral española polo Observatorio Global do Cancro. Resultados: Despois dunha mediana de seguimento de 4,07 anos de 1.909 pacientes consecutivos con IC, diagnosticáronse 165 novos casos de malignidade. As taxas de incidencia estandarizadas por idade por 100.000 persoas-anos foron de 861 casos [intervalo de confianza (ICo) 95% 618,4–2.159,4] en homes e 728,5 casos (ICo 95% 451,1–4.308,7) en mulleres no grupo de IC; mentres que as taxas de incidencia estandarizadas por idade por 100.000 persoas-anos para a poboación española foron 479,4 casos en homes (risco relativo = 1,80) e 295,5 casos en mulleres (risco relativo = 2,46). Tanto o antecedente de neoplasia como o diagnóstico dunha nova neoplasia no seguimento, foron asociadas cunha menor supervivencia. As taxas de mortalidade relacionada co cancro estandarizadas por idade por 100.000 persoas-anos foron 344,1 mortes (ICo 95% 202,1–1675) en homes e 217 mortes (ICo 95% 32,8–3949,3) en mulleres no grupo de IC, mentres que as taxas de mortalidade relacionada co cancro estandarizadas por idade por 100.000 persoas-anos para a poboación xeral española foron 201,4 mortes en homes (risco relativo = 1,71) e 96,2 mortes en mulleres (risco relativo = 2,26). Conclusións: Os pacientes con IC mostraron taxas mais elevadas na incidencia de novo diagnóstico de cancro e de mortalidade relacionada co cancro que o esperado para a poboación xeral, tanto en homes como en mulleres, sendo a supervivencia tras un novo diagnóstico de neoplasia pobre.