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N-Terminal Pro-Brain Natriuretic Peptide Is Associated with a Future Diagnosis of Cancer in Patients with Coronary Artery Disease

By José Tuñón (474679), Javier Higueras (750432), Nieves Tarín (584983), Carmen Cristóbal (584982), Óscar Lorenzo (2283061), Luis Blanco-Colio (750433), José Luis Martín-Ventura (3171831), Ana Huelmos (584986), Joaquín Alonso (584987), Álvaro Aceña (584984), Ana Pello (750434), Rocío Carda (584991), Dolores Asensio (331512), Ignacio Mahíllo-Fernández (584989), Lorenzo López Bescós (750435), Jesús Egido (108393) and Jerónimo Farré (584992)


<div><p>Objective</p><p>Several papers have reported elevated plasma levels of natriuretic peptides in patients with a previous diagnosis of cancer. We have explored whether N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma levels predict a future diagnosis of cancer in patients with coronary artery disease (CAD).</p><p>Methods</p><p>We studied 699 patients with CAD free of cancer. At baseline, NT-proBNP, galectin-3, monocyte chemoattractant protein-1, soluble tumor necrosis factor-like weak inducer of apoptosis, high-sensitivity C-reactive protein, and high-sensitivity cardiac troponin I plasma levels were assessed. The primary outcome was new cancer diagnosis. The secondary outcome was cancer diagnosis, heart failure requiring hospitalization, or death.</p><p>Results</p><p>After 2.15±0.98 years of follow-up, 24 patients developed cancer. They were older (68.5 [61.5, 75.8] vs 60.0 [52.0, 72.0] years; p=0.011), had higher NT-proBNP (302.0 [134.8, 919.8] vs 165.5 [87.4, 407.5] pg/ml; p=0.040) and high-sensitivity C-reactive protein (3.27 [1.33, 5.94] vs 1.92 [0.83, 4.00] mg/L; p=0.030), and lower triglyceride (92.5 [70.5, 132.8] vs 112.0 [82.0, 157.0] mg/dl; p=0.044) plasma levels than those without cancer. NT-proBNP (Hazard Ratio [HR]=1.030; 95% Confidence Interval [CI]=1.008-1.053; p=0.007) and triglyceride levels (HR=0.987; 95%CI=0.975-0.998; p=0.024) were independent predictors of a new cancer diagnosis (multivariate Cox regression analysis). When patients in whom the suspicion of cancer appeared in the first one-hundred days after blood extraction were excluded, NT-proBNP was the only predictor of cancer (HR=1.061; 95%CI=1.034-1.088; p<0.001). NT-proBNP was an independent predictor of cancer, heart failure, or death (HR=1.038; 95%CI=1.023-1.052; p<0.001) along with age, and use of insulin and acenocumarol.</p><p>Conclusions</p><p>NT-proBNP is an independent predictor of malignancies in patients with CAD. New studies in large populations are needed to confirm these findings.</p></div

Topics: Biological Sciences, Coronary Artery Disease ObjectiveSeveral papers, multivariate Cox regression analysis, hr, cancer diagnosis, Heart failure, predictor, vs, cad, plasma levels, ci
Year: 2015
DOI identifier: 10.1371/journal.pone.0126741
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Provided by: FigShare
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