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Cardiovascular biomarkers in patients with cancer and their association with all-cause mortality
Open accessAbstract
Objective: Patients with cancer may display elevated levels of B-type natriuretic peptide (BNP) and high-sensitive troponin T (hsTnT) without clinical manifestation of cardiac disease. This study aimed to evaluate circulating cardiovascular hormones and hsTnT and their association with mortality in cancer. Methods: We prospectively enrolled 555 consecutive patients with a primary diagnosis of cancer and without prior cardiotoxic anticancer therapy. N-terminal pro BNP (NT-proBNP), mid-regional pro-atrial natriuretic peptide (MR-proANP), mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), copeptin, hsTnT, proinflammatory markers interleukin 6 (IL-6) and C reactive protein (CRP), and cytokines serum amyloid A (SAA), haptoglobin and fibronectin were measured. All-cause mortality was defined as primary endpoint. Results: During a median follow-up of 25 (IQR 16–31) months, 186 (34%) patients died. All cardiovascular hormones and hsTnT levels rose with tumour stage progression. All markers were significant predictors of mortality with HRs per IQR of 1.54 (95% CI 1.24 to 1.90, p<0.001) for NT-proBNP, 1.40 (95% CI 1.10 to 1.79, p<0.01) for MR-proANP, 1.31 (95% CI 1.19 to 1.44, p<0.001) for MR-proADM, 1.21 (95% CI 1.14 to 1.30, p<0.001) for CT-proET-1, 1.22 (95% CI 1.04 to 1.42, p=0.014) for copeptin and 1.21 (95% CI 1.13 to 1.32, p<0.001) for hsTnT, independent of age, gender, tumour entity and stage, and presence of cardiac comorbidities. NT-proBNP, MR-proANP, MR-proADM and hsTnT displayed a significant correlation with IL-6 and CRP. Conclusions: Circulating levels of cardiovascular peptides like NT-proBNP, MR-proANP, MR-proADM, CT-pro-ET-1 and hsTnT were elevated in an unselected population of patients with cancer prior to induction of any cardiotoxic anticancer therapy. The aforementioned markers and copeptin were strongly related to all-cause mortality, suggesting the presence of subclinical functional and morphological myocardial damage directly linked to disease progression.
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Cancer survival: global surveillance will stimulate health policy and improve equity
Coleman, M. P. (2014) · The Lancet · doi:10.1016/s0140-6736(13)62225-4 · Cited by 370
Cited by
Application of Light Scattering Techniques to Nanoparticle Characterization and Development
Carvalho, P. M., Felício, M. R., Santos, N. C., Gonçalves, S., & Domingues, M. M. (2018) · Frontiers in Chemistry · doi:10.3389/fchem.2018.00237 · Cited by 402
Metadata
- Authors
- Pavo, N., Raderer, M., Hülsmann, M., Neuhold, S., Adlbrecht, C., Strunk, G., Goliasch, G., Gisslinger, H., Steger, G. G., Hejna, M., Köstler, W., Zöchbauer-Müller, S., Marosi, C., Kornek, G., Auerbach, L., Schneider, S., Parschalk, B., Scheithauer, W., Pirker, R., Drach, J., Zielinski, C., & Pacher, R.
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2015-09-28
- Volume
- 101
- Issue
- 23
- Pages
- 1874-1880
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2174747373
- Cited by
- 269
- References
- 1
- FWCI
- 12.27
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Pavo, N., Raderer, M., Hülsmann, M., Neuhold, S., Adlbrecht, C., Strunk, G., Goliasch, G., Gisslinger, H., Steger, G. G., Hejna, M., Köstler, W., Zöchbauer-Müller, S., Marosi, C., Kornek, G., Auerbach, L., Schneider, S., Parschalk, B., Scheithauer, W., Pirker, R., . . . Pacher, R. (2015). Cardiovascular biomarkers in patients with cancer and their association with all-cause mortality. Heart. https://doi.org/10.1136/heartjnl-2015-307848
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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