Tumour biomarkers: association with heart failure outcomes.
Aged
Antigens, Neoplasm
/ blood
Antigens, Tumor-Associated, Carbohydrate
/ blood
Biomarkers, Tumor
/ blood
CA-125 Antigen
/ blood
Carcinoembryonic Antigen
/ blood
Female
Follow-Up Studies
Heart Failure
/ blood
Hospitalization
Humans
Keratin-19
/ blood
Male
Membrane Proteins
/ blood
Natriuretic Peptide, Brain
/ blood
Peptide Fragments
/ blood
alpha-Fetoproteins
/ analysis
biomarkers
heart failure
natriuretic peptides
neoplasms
tumour
Journal
Journal of internal medicine
ISSN: 1365-2796
Titre abrégé: J Intern Med
Pays: England
ID NLM: 8904841
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
16
01
2020
revised:
18
02
2020
accepted:
25
02
2020
pubmed:
7
5
2020
medline:
2
2
2021
entrez:
7
5
2020
Statut:
ppublish
Résumé
There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics. To explore the association between tumour biomarkers and HF outcomes. In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers: CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP. During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P < 0.001, P for trend < 0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P < 0.0001), 1.45 (95% CI 1.30-1.61; P < 0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P < 0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP). Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF.
Sections du résumé
BACKGROUND
There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics.
OBJECTIVES
To explore the association between tumour biomarkers and HF outcomes.
METHODS
In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers: CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP.
RESULTS
During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P < 0.001, P for trend < 0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P < 0.0001), 1.45 (95% CI 1.30-1.61; P < 0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P < 0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP).
CONCLUSIONS
Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF.
Identifiants
pubmed: 32372544
doi: 10.1111/joim.13053
pmc: PMC7496322
doi:
Substances chimiques
Antigens, Neoplasm
0
Antigens, Tumor-Associated, Carbohydrate
0
Biomarkers, Tumor
0
CA-125 Antigen
0
Carcinoembryonic Antigen
0
Keratin-19
0
MUC16 protein, human
0
Membrane Proteins
0
Peptide Fragments
0
alpha-Fetoproteins
0
antigen CYFRA21.1
0
carbohydrate antigen 199, human
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
207-218Informations de copyright
© 2020 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.
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