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N-terminal Pro-brain Natriuretic Peptide plasma levels are Associated With a Short-Term Diagnosis of Cancer in Patients with Coronary Artery Disease
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  • Jose Tuñon,
  • Alvaro Aceña,
  • Ana Pello,
  • Sergio Ramos-Cillan,
  • Juan Martínez Milla,
  • Oscar Gonzalez-Lorenzo,
  • Jesus Fuentes-Antras,
  • Nieves Tarin,
  • Carmen Cristobal,
  • Luis M. Blanco-Colío,
  • Jose Luis Martin-Ventura,
  • Ana Huelmos,
  • Carlos Gutierrez-Landaluce,
  • Joaquin Alonso,
  • Lorenzo Lopez-Bescós,
  • Marta Lopez-Castillo,
  • Luis Alonso-Pulpón,
  • Jesus Egido,
  • Ignacio Mahillo-Fernandez,
  • Oscar Lorenzo
Jose Tuñon
Hospital Universitario Fundacion Jimenez Diaz
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Alvaro Aceña
Hospital Universitario Fundacion Jimenez Diaz
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Ana Pello
Hospital Universitario Fundacion Jimenez Diaz
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Sergio Ramos-Cillan
Universidad Autonoma de Madrid
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Juan Martínez Milla
Hospital Universitario Fundacion Jimenez Diaz
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Oscar Gonzalez-Lorenzo
Hospital Universitario Fundacion Jimenez Diaz
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Jesus Fuentes-Antras
Hospital Clinico Universitario San Carlos
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Nieves Tarin
Hospital Universitario de Mostoles
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Carmen Cristobal
Hospital Universitario de Fuenlabrada
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Luis M. Blanco-Colío
Hospital Universitario Fundacion Jimenez Diaz
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Jose Luis Martin-Ventura
Universidad Autonoma de Madrid
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Ana Huelmos
Hospital Universitario Fundacion Alcorcon
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Carlos Gutierrez-Landaluce
Hospital Universitario de Fuenlabrada
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Joaquin Alonso
Hospital Universitario de Getafe
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Lorenzo Lopez-Bescós
Universidad Rey Juan Carlos
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Marta Lopez-Castillo
Hospital Universitario Fundacion Jimenez Diaz
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Luis Alonso-Pulpón
Hospital Universitario Puerta de Hierro Majadahonda
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Jesus Egido
Fundacion Jimenez Diaz Hospital
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Ignacio Mahillo-Fernandez
Hospital Universitario Fundacion Jimenez Diaz
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Oscar Lorenzo
Universidad Autonoma de Madrid
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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

Peer review status:UNDER REVIEW

01 Apr 2020Submitted to International Journal of Clinical Practice
11 Apr 2020Assigned to Editor
11 Apr 2020Submission Checks Completed
12 Apr 2020Reviewer(s) Assigned