{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:35:52Z","timestamp":1785825352739,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,5,31]],"date-time":"2020-05-31T00:00:00Z","timestamp":1590883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004702","name":"Universit\u00e0 degli Studi di Genova","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004702","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cancer complicating heart failure (HF) is an emerging issue. We investigated it in the GISSI\u2010HF trial, which uniquely included patients with malignancies if deemed likely to allow follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>At enrolment, 256 of 6913 participants in GISSI\u2010HF (3.7%) had a tumour diagnosis, which was malignant (cancer) in 145 (2.1%). Patients with cancer were older and more often former smokers, had lower body mass index, lower left ventricular ejection fraction (LVEF), less implanted devices, lower glucose and haemoglobin and higher uric acid levels than those without cancer. During a median 4\u2010year follow\u2010up, cardiovascular (CV), non\u2010CV non\u2010cancer and cancer death occurred in 1477, 272 and 220 subjects (75%, 13.8% and 11.2% of total mortality, respectively). Cancer at trial entry portended an increased risk of all\u2010cause mortality after accounting for age and confounders (HR 1.33, 95%CI 1.02\u20101.73), which was attributable to cancer\u2010specific mortality. Among the 6657 patients without any tumour at enrolment, 1879 subsequently died. CV, non\u2010CV non\u2010cancer and cancer causes accounted for 1422 (75.7%), 261 (13.9%) and 196 (10.4%) of these deaths, respectively, median time to specific death being 22, 25 and 30\u00a0months (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Patients facing cancer vs CV death had lower NYHA class, slower heart rate, higher blood pressure, higher LVEF, shorter HF history, less diuretic use, lower creatinine and uric acid and higher haemoglobin and cholesterol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Even when considered not aggressive, concomitant cancer worsens HF prognosis. The inverse relationship between HF severity and cancer death in the absence of prior tumour warrants further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13273","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T10:34:31Z","timestamp":1589452471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cancer in chronic heart failure patients in the GISSI\u2010HF trial"],"prefix":"10.1111","volume":"50","author":[{"given":"Pietro","family":"Ameri","sequence":"first","affiliation":[{"name":"Cardiovascular Disease Unit IRCCS Ospedale Policlinico San Martino IRCCS Italian Cardiovascular Network Genova Italy"},{"name":"Department of Internal Medicine University of Genova Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Canepa","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit IRCCS Ospedale Policlinico San Martino IRCCS Italian Cardiovascular Network Genova Italy"},{"name":"Department of Internal Medicine University of Genova Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian","family":"Luigi Nicolosi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Santa Maria degli Angeli Hospital Pordenone Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Marchioli","sequence":"additional","affiliation":[{"name":"Therapeutic Science and Strategy Unit (TSSU) IQVIA Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Latini","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Research IRCCS\u2010Istituto di Ricerche Famacologiche Mario Negri Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Scientific Direction Maria Cecilia Hospital GVM Care and Research Ettore Sansavini Health Science Foundation Cotignola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2764-6779","authenticated-orcid":false,"given":"Aldo P.","family":"Maggioni","sequence":"additional","affiliation":[{"name":"ANMCO Research Centre Florence, Fondazione per il Tuo cuore \u2013 HCF onlus Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the GISSI\u2010HF Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1165"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.3593"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13033"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12450"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.04.053"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.088"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.472"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2017.45"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.069"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033603"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.030816"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2004.03.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61239-8"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr213"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv366"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu131"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.967828"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-19-0279"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.09.013"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-019-02060-0"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.781"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Feci.13273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.13273","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T07:42:13Z","timestamp":1693899733000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.13273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,31]]},"references-count":22,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/eci.13273"],"URL":"https:\/\/doi.org\/10.1111\/eci.13273","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,31]]},"assertion":[{"value":"2020-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13273"}}