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@ARTICLE{Anker:304276,
      author       = {M. S. Anker and A. A. Mahabadi and M. Totzeck and M. Tewes
                      and M. Shahzeb Khan and R. I. Mincu and U. B. Hendgen-Cotta
                      and L. Michel and B. Mathew and O. Drescher and M. Schuler
                      and U. Keller$^*$ and K. Rieger and J. Ahn and L.
                      Bullinger$^*$ and D. P. Modest$^*$ and C. Denecke and L.
                      Kretzler and L. V. Ramer and D. Krug and U. Landmesser and
                      L. Lehmann and N. Frey and S. Bercker and U. Laufs and M.
                      Böhm and F. Mahfoud and B. Merkely and M. Diek and J.
                      Butler and A. Veiser and T. Heise and M. Hellmich and M.
                      Placzek and T. Friede and S. D. Anker and T. Rassaf},
      title        = {{H}eart {F}ailure {T}herapy in {P}atients with {A}dvanced
                      {C}ancer {R}eceiving {S}pecialized {P}alliative {C}are
                      ({EMPATICC} trial).},
      journal      = {European heart journal},
      volume       = {nn},
      issn         = {0195-668X},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2025-01817},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Advanced cancer may resemble a heart failure (HF)-like
                      phenotype marked by cardiac wasting, dyspnoea, congestion,
                      and/or physical dysfunction. The trial evaluated safety and
                      efficacy of HF therapy among patients with advanced cancer
                      receiving specialized palliative care to improve patients'
                      self-care ability.Patients with stage 4 solid tumours with a
                      life expectancy of 1-6 months receiving specialized
                      palliative care were enrolled. Patients were required to
                      meet at least two cardiovascular risk criteria and at least
                      one criterion for functional limitation. Participants were
                      randomized 1:1 to receive optimised HF therapy (up to 4
                      drugs: sacubitril/valsartan, empagliflozin, ivabradine,
                      ferric carboxymaltose) or placebo in a double-blind setting.
                      The primary hierarchical endpoint included: (1) days alive
                      and able to wash oneself, (2) ability to walk 4 m, (3)
                      self-reported patient global assessment (PGA) of subjective
                      well-being, during the 30-day placebo-controlled phase.In 5
                      centers, 93 patients were randomized. The primary endpoint
                      did not differ between groups (win ratio 0.95, $95\%$
                      confidence interval [CI] 0.57-1.58; P=0.83). Overall,
                      mortality was $32\%$ at 30 days (not different between
                      groups). In patients alive at 30 days, HF therapy reduced
                      N-terminal pro-B-type natriuretic peptide levels by $41\%$
                      (P=0.040), increased left ventricular ejection fraction by
                      $2.9\%$ (P=0.036), and improved PGA scores (odds ratio 0.22,
                      $95\%$ CI 0.06-0.75; P=0.016).In a population with advanced
                      cancer receiving specialized palliative care and high early
                      mortality, optimised HF therapy did not improve patients'
                      self-care ability. Among survivors at 30 days, improvements
                      in quality of life measures and cardiac biomarkers suggest
                      potential benefit of individualized HF therapy, which is
                      hypothesis generating and needs validation.},
      keywords     = {Heart failure therapy (Other) / cardiac wasting (Other) /
                      clinical trial (Other) / end-stage cancer (Other) /
                      palliative care (Other)},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40884070},
      doi          = {10.1093/eurheartj/ehaf705},
      url          = {https://inrepo02.dkfz.de/record/304276},
}