{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T20:07:25Z","timestamp":1784318845008,"version":"3.55.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":176,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>End-stage cancer may resemble a heart failure (HF)-like phenotype marked by cardiac wasting, dysfunction, and symptoms such as dyspnoea, congestion, and impaired physical function. The EMPATICC (EMPower the heArt of patients with TermInal Cancer using Cardiac medicines) trial evaluates the safety and efficacy of optimized HF therapy in patients with advanced cancer to improve self-care ability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>EMPATICC is a multicentre, investigator-initiated, randomized, double-blind, controlled, proof-of-concept trial employing a joint cardio-oncology care approach. Patients were randomized 1:1 to optimized HF therapy (sacubitril\/valsartan, empagliflozin, ivabradine, ferric carboxymaltose) plus usual care, or usual care alone, for 30\u2009days, followed by a 30-day open-label extension. Eligible patients had stage IV solid tumours (per Union for International Cancer Control), were receiving palliative care, had a 1\u20136\u2009month life expectancy, and were on optimized analgesia. At baseline, first patients had to meet \u22652 criteria of the following indicating cardiovascular risk: heart rate\u2009\u226570\u2009bpm, N-terminal pro-B-type natriuretic peptide \u2265600\u2009pg\/ml, elevated high-sensitivity troponin, left ventricular ejection fraction &amp;lt;55%, left ventricular mass loss &amp;gt;15%, transferrin saturation\u2009&amp;lt;20%, or moderate\/high likelihood of HF with preserved ejection fraction (based on the HFA-PEFF score); and they had to meet at least one criterion of the following indicating functional limitation: \u22656\u2009s to walk 4\u2009m, inability to wash \u22653\u2009days of the last 7\u2009days, or symptoms of dyspnoea at rest. Enrolment ended 30 January 2025; 93 patients completed randomization. The primary endpoint is a hierarchical composite (analysed by win ratio): (1) days alive and able to wash, (2) 4\u2009m walking ability, and (3) patient global assessment of well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EMPATICC evaluates whether HF therapy can improve function and well-being in advanced cancer, potentially reshaping care in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3799","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T15:44:48Z","timestamp":1756223088000},"page":"1905-1917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Randomized Investigation of Heart Failure Therapy in Patients with Advanced Cancer at Risk of Cardiac Wasting: Rationale and Design of the EMPATICC Trial"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4406-8555","authenticated-orcid":false,"given":"Markus S.","family":"Anker","sequence":"first","affiliation":[{"name":"Charit\u00e9\u2014University Medicine Berlin Corporate Member of Free University Berlin and Humboldt-University Berlin , Berlin ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research Partner Site Berlin , Berlin ,","place":["Germany"]},{"name":"Department of Cardiology, Angiology and Intensive Care Medicine CBF, German Heart Center Charit\u00e9 , Berlin ,","place":["Germany"]},{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir A.","family":"Mahabadi","sequence":"additional","affiliation":[{"name":"West German Heart and Vascular Center, Clinic of Cardiology and Vascular Medicine, University Hospital Essen, University of Duisburg-Essen , 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Shahzeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute , Dallas, TX ,","place":["USA"]},{"name":"Baylor Scott and White The Heart Hospital-Plano , Plano, TX ,","place":["USA"]},{"name":"Department of Medicine, Baylor College of Medicine , Temple, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute , Dallas, TX ,","place":["USA"]},{"name":"Department of Medicine, University of Mississippi Medical Center , Jackson, MS ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Cancer Immunology, Charit\u00e9\u2014University Medicine Berlin, Campus Benjamin-Franklin , Berlin ,","place":["Germany"]},{"name":"German Cancer Research Center and German 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Charit\u00e9, Charit\u00e9-Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]},{"name":"Friede Springer Cardiovascular Prevention Center at Charit\u00e9, DZHK, Partner Site Berlin, Berlin Institute of Health , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz H.","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, and Pneumology, Heidelberg University Hospital, German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Bercker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, University Hospital Leipzig , Leipzig ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Laufs","sequence":"additional","affiliation":[{"name":"Klinik 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