Cancer survivors remain at increased risk of heart failure (HF), partly related to prior cancer therapy and shared cardiometabolic risk pathways. An observational study published in Open Heart evaluated whether elevated C-reactive protein (CRP), a marker of chronic low-grade inflammation, was associated with incident HF in cancer survivors.

The analysis included 20,244 UK Biobank participants with cancer at baseline, including 7,108 men, with a mean age of 60 years. The primary endpoint was incident HF. Competing risk regression with Cox proportional hazards models was used to assess associations after adjustment for sociodemographic, lifestyle, and clinical variables.

Over a median follow-up of 10.5 ± 1.2 years, 401 participants developed HF, corresponding to an incidence rate of 2.0 per 100 individuals. CRP levels greater than 2 mg/L were associated with a 53% higher risk of incident HF compared with lower levels (subdistribution hazard ratio [sHR] 1.53; 95% confidence interval [CI] 1.24-1.88; P < .001).

Subgroup analyses showed a consistent association between elevated CRP and HF risk across examined groups. Cancer type-stratified analyses found the strongest association among survivors of cutaneous malignancies.

The findings suggest elevated CRP was associated with higher long-term HF risk in cancer survivors and may help identify individuals who warrant closer cardiovascular follow-up.