Higher baseline levels of certain cardiac biomarkers were associated with an increased risk of future incidence of cancer, according to findings from a study published in the Journal of the American College of Cardiology: Advances.
Higher incidence rates for all cancers were associated with higher baseline levels of both high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), especially in the highest quartiles.
“These biomarkers are already well-known indicators of cardiovascular risk, but our findings suggest their predictive power may reach well beyond heart disease to encompass cancer risk too,” stated lead study author Xinjiang Cai, MD, PhD, a cardiologist and physician-scientist at UCLA Health. “The idea that slight elevations of heart-related blood markers might also help flag cancer risk in people with no known heart problems highlights how interconnected cardiovascular health and cancer may be, beyond just their shared common risk factors.”
Study Methods and Results
The researchers analyzed prospective data from 6,244 participants in the MESA (Multi-Ethnic Study of Atherosclerosis) study; this cohort of adult participants between 45 and 85 years did not have cancer or cardiovascular disease at baseline between 2000 and 2002.
These participants were followed for a median of 17.8 years, and during that period, 820 participants developed cancer, for an incidence rate of 91.2 cases per 10,000 person-years. The median time to cancer detection was 7.95 years.
The incidence of all cancers increased with greater hs-cTnT levels, though the trend of greater rates of cancer with higher hs-cTnT levels was not consistent across groupings of hs-cTnT levels. Those with levels in the highest category (hs-cTnT ≥ 8.80 ng/L) showed a 2.8-fold increase in the occurrence rate of all cancers.
Higher cancer incidence rates aligned with elevated NT-proBNP levels divided by quartiles, and those in the highest quartile (NT-proBNP ≥ 102.9 ng/L) showed a 2.1-fold increase in the occurrence rate of all cancers compared with those in the lowest quartile (< 22.8 ng/L). Breast cancer and other female-specific cancers were exceptions to the trend, with NT-proBNP levels in the third quartile showing a substantially lower cancer incidence rate than the first two quartiles.
Hazard ratios were calculated with minimally adjusted and fully adjusted models for the impact of hs-cTnT and NT-proBNP levels on risk for all cancers. The variables for the fully adjusted models included age, race/ethnicity, study site, sex, BMI, education, health insurance status, diabetes, hypertension medication, systolic blood pressure, total cholesterol, HDL-C, smoking status, pack years of cigarette smoking, statins, and estimated glomerular filtration rate. The fully adjusted hazard ratio for hs-cTnT levels on all cancers was 1.176 (95% confidence interval [CI] = 1.086–1.273; P < .001) and 2.412 (95% CI = 1.295–4.491; P = .006) for NT-proBNP levels.
Sex and race/ethnicity did not significantly affect any of the associations between hs-cTnT and NT-proBNP levels on risk for all cancers.
“These findings can help bridge the knowledge gap at the intersection of preventive cardiology and oncology and can lead to better risk prediction and prevention strategies for both diseases,” Dr. Cai said.
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
