BACKGROUND
Patients with coronary artery disease (CAD) are at risk of developing
malignancies, given that cancer shares some risk factors with this
disorder, as age, smoking, and even some dietary
patterns1-3. Then, finding biomarkers that predict
both the risk of cancer and of cardiovascular events could be useful in
CAD patients.
Natriuretic peptides are secreted by cancer cells4, 5and N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP)
levels are increased in patients with cancer6.
Previously, we have reported that NT-proBNP plasma levels predict a
future diagnosis of cancer in 704 patients with CAD from the Biomarkers
in Acute Coronary Syndrome & Biomarkers in Acute Myocardial Infarction
(BACS & BAMI) studies7. We launched the hypothesis
that NT-proBNP could be merely detecting subclinical cancers rather than
being a real predictor. Now we try to support this hypothesis by
analyzing if this biomarker predicts a new cancer diagnosis only in the
short-term but not in the long-run. For that purpose we have expanded
the sample size and the follow-up of the same population, studying 962
patients with CAD free of malignancies at baseline, who developed 59
cancers at follow-up. We divided them into those receiving a cancer
diagnosis in the first three years and those receiving this diagnosis
beyond this time. Along with NT-proBNP, we also tested these biomarkers:
monocyte chemoattractant protein-1 (MCP-1), involved in inflammation and
atherothrombosis, among other processes8, 9;
galectin-3, related to malignancies, heart failure, thrombosis, and
renal dysfunction10, 11; high-sensitivity cardiac
troponin I (hsTnI), which has been described to have prognostic value in
stable CAD12; and vitamin D (calcidiol) plasma levels,
as low levels of this molecule have been related to
cancer13. High-sensitivity C-reactive protein (hsCRP)
was studied as a reference given the large amount of information
published on this biomarker on cardiovascular disease.