N-terminal Pro-brain Natriuretic Peptide plasma levels are Associated
With a Short-Term Diagnosis of Cancer in Patients with Coronary Artery
Disease
Abstract
Background NT-proBNP plasma levels may predict a future cancer
diagnosis(CD)in patients with coronary artery disease(CAD).In this paper
we test whether this could merely represent the detection of increased
NT-proBNP levels in subclinical tumors. Methods We studied 962 patients
with stable CAD and free of cancer and heart failure at baseline.
NT-proBNP, galectin-3, monocyte chemoattractant
protein-1,high-sensitivity C-reactive protein, high-sensitivity cardiac
troponin I(hsTnI),and calcidiol plasma levels were assessed.The primary
outcome was new CD. Results After 5.40(2.81-6.94)years of follow-up,59
patients received a CD.We divided the population in three subgroups:
those not developing cancer during follow-up (group A;N=903),and those
receiving a CD in the first 3 years of follow up(group B; N=30),or later
(group C;N=29).At baseline, 3.3% of patients of group B,0.0% in groups
C and 12.3% in group A(p=0.036) presented a previous history of heart
failure.In group B,NT-proBNP[HR1.036 CI(1.015-1.056)per increase in
100 pg/ml;p=0.001],previous atrial fibrillation[HR3.140
CI(1.196-8.243);p=0.020],and previous heart failure[HR0.067
CI(0.006-0.802);p=0.033]were independent predictors of CD at
multivariate analysis.In group C there were not significant predictors
of CD. Conclusions In patients with CAD,NT-proBNP is an independent
predictor of CD in the first three years of follow-up,but not
later,suggesting that it could be detecting subclinical undiagnosed
cancers.New studies in large populations are needed to confirm these
findings. What is already known about this topic? It has been linked in
previous studies that NT-Pro-BNP elevation could be related to future
diagnosis of some cancers especially renal tumors. It has also seen that
NT-ProBNP is related to mortality in cancer patients.Finally, our group
has previously seen that NT-Pro-BNP predicts cancer diagnosis in
patients with myocardial infarction. What does this article add?
According to our previous investigations this study support the idea
that NT-Pro-BNP is a good marker for further cancer diagnosis not only
in patients with myocardial infarction but across the spectrum of the
whole CAD