Data Resource Profile: The Virtual Cardio-Oncology Research Initiative (VICORI) linking national English cancer registration and cardiovascular audits.

Key FeaturesThe Virtual Cardio-Oncology Research Initiative (VICORI) programme brings together English national cancer data and six national cardiovascular disease audits to investigate the interplay between cardiovascular disease and cancer.The VICORI data resource captures adults (aged 18+ years) who were hospitalized for cardiac disease, had a cardiac procedure and/or a cancer diagnosis alongside information on their treatment and outcomes. These data are routinely collected and submitted to health care registries and are linked using a unique health service number.Detailed data on cancer and cardiac diagnosis, treatment, outcomes, previous and subsequent hospital diagnoses and operations, and mortality are available from 6.2 million cancer diagnoses between 1995 and 2018, and 3.8 million cardiac hospital admissions/procedures between 1999 and 2018.The VICORI cohort will be updated on a rolling basis with annual updates from the audits.</ul

Acute heart failure presentation, management and outcomes in cancer patients: a national longitudinal study.

Aims Currently, little evidence exists on survival and quality of care in cancer patients presenting with acute heart failure (HF). The aim of the study is to investigate the presentation and outcomes of hospital admission with acute HF in a national cohort of patients with prior cancer. Methods and results This retrospective, population-based cohort study identified 221 953 patients admitted to a hospital in England for HF during 2012–2018 (12 867 with a breast, prostate, colorectal, or lung cancer diagnosis in the previous 10 years). We examined the impact of cancer on (i) HF presentation and in-hospital mortality, (ii) place of care, (iii) HF medication prescribing, and (iv) post-discharge survival, using propensity score weighting and model-based adjustment. Heart failure presentation was similar between cancer and non-cancer patients. A lower percentage of patients with prior cancer were cared for in a cardiology ward [−2.4% age point difference (ppd) (95% CI −3.3, −1.6)] or were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists (ACEi/ARB) for heart failure with reduced ejection fraction [−2.1 ppd (−3.3, −0.9)] than non-cancer patients. Survival after HF discharge was poor with median survival of 1.6 years in prior cancer and 2.6 years in non-cancer patients. Mortality in prior cancer patients was driven primarily by non-cancer causes (68% of post-discharge deaths). Conclusion Survival in prior cancer patients presenting with acute HF was poor, with a significant proportion due to non-cancer causes of death. Despite this, cardiologists were less likely to manage cancer patients with HF. Cancer patients who develop HF were less likely to be prescribed guideline-based HF medications compared with non-cancer patients. This was particularly driven by patients with a poorer cancer prognosis.</p