N-terminal pro-brain natriuretic peptide is associated with a future diagnosis of cancer in patients with coronary artery disease
Metadatos
Title:
N-terminal pro-brain natriuretic peptide is associated with a future diagnosis of cancer in patients with coronary artery disease
Author:
Tuñón, José; Higueras, Javier; Tarín, Nieves; Cristóbal, Carmen; Lorenzo, Óscar; Blanco-Colio, Luis; Martín-Ventura, José Luis; Huelmos, Ana; Alonso, Joaquín; Aceña, Álvaro; Pello, Ana María; Carda, Rocío; Asensio, Dolores; Mahillo, Ignacio; López Bescós, Lorenzo; Egido, Jesús; Farré, Jerónimo
Entity:
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD)
UAM Author:
Aceña Navarro, Álvaro
; Tuñón Fernández, José Luis
Publisher:
Public Library of Science
Date:
2015-06-05
Citation:
10.1371/journal.pone.0126741
PLOS ONE 10.6 (2015); e0126741
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0126741
Funded by:
This work was supported by grants from
Fondo de Investigaciones Sanitarias (PI05/0451,
PI05/1497,PI05/2475, PI05/1043, PS09/01405, PI10/
00072, and PI10/0234, PI14/1567, Programa de
Estabilización to LBC); Spanish Society of Cardiology
and Spanish Heart Foundation; Spanish Society of
Arteriosclerosis; RECAVA (RD06/0014/0035, www.
recava.com); Fundación Lilly; and Instituto de Salud
Carlos III FEDER (FJD biobank: RD09/0076/00101).
Editor's Version:
http://dx.doi.org/10.1371/journal.pone.0126741
Subjects:
Natriuretic peptides; Cancer; Coronary artery disease; Medicina
Rights:
© 2015 Tuñón et al.
Abstract:
Objective
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).
Methods
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.
Results
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.
Conclusions
NT-proBNP is an independent predictor of malignancies in patients with CAD. New studies
in large populations are needed to confirm these findings
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