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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.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehae105","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T17:50:22Z","timestamp":1709661022000},"page":"1224-1240","source":"Crossref","is-referenced-by-count":39,"title":["Heart failure pharmacotherapy and cancer: pathways and pre-clinical\/clinical evidence"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2236-2881","authenticated-orcid":false,"given":"Nabil V","family":"Sayour","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Pharmacotherapy, Semmelweis University , H-1085 Budapest, \u00dcll\u0151i \u00fat 26 , Hungary"},{"name":"HCEMM-SU Cardiometabolic Immunology Research Group , H-1089 Budapest, Nagyv\u00e1rad t\u00e9r 4 , Hungary"},{"name":"MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group , H-1089 Budapest, Nagyv\u00e1rad t\u00e9r 4 , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1gnes M","family":"Pa\u00e1l","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacotherapy, Semmelweis University , H-1085 Budapest, \u00dcll\u0151i \u00fat 26 , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Ameri","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Italian IRCCS Cardiology Network , Genova , Italy"},{"name":"Department of Internal Medicine, University of Genova , Genova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter C","family":"Meijers","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thorax Center, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5678-6175","authenticated-orcid":false,"given":"Giorgio","family":"Minotti","sequence":"additional","affiliation":[{"name":"University Campus Bio-Medico , Via \u00c1lvaro del Portillo, 21, 00128 Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Andreadou","sequence":"additional","affiliation":[{"name":"Laboratory of Pharmacology, School of Pharmacy, National and Kapodistrian University of Athens, Athens , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart , Rome , Italy"},{"name":"Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-5349","authenticated-orcid":false,"given":"Massimiliano","family":"Camilli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart , Rome , Italy"},{"name":"Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Drexel","sequence":"additional","affiliation":[{"name":"Vorarlberg Institute for Vascular Investigation & Treatment (VIVIT) , Carinagasse 47, A-6800 Feldkirch, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik Lerkevang","family":"Grove","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health, Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gheorghe Andrei","family":"Dan","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy , Colentina University Hospital, Bucharest , Romania"},{"name":"Cardiology Department, Colentina Clinical Hospital , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Ivanescu","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy , Colentina University Hospital, Bucharest , Romania"},{"name":"Cardiology Department, Colentina Clinical Hospital , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Grete","family":"Semb","sequence":"additional","affiliation":[{"name":"Division of Research and Innovation, REMEDY-Centre for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital , Oslo , Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm , Sweden"},{"name":"Heart and Vascular and Neuro Theme, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-117X","authenticated-orcid":false,"given":"Dobromir","family":"Dobrev","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen , Essen , Germany"},{"name":"Department of Medicine and Research Center, Montreal Heart Institute and Universit\u00e9 de Montr\u00e9al , Montr\u00e9al, QC , Canada"},{"name":"Department of Integrative Physiology, Baylor College of Medicine , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Crea","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart , Rome , Italy"},{"name":"Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. 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