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. 2024 Aug 26;31(9):4927-4939.
doi: 10.3390/curroncol31090365.

Association of Cancer with Heart Failure and the Prognostic Value of NT-proBNP in Cancer Patients: Findings from the NHANES (1999-2018)

Qingping Zeng  1   2 , Weihong Chang  1   2 , Rui Zhang  1   2 , Hongxuan Fan  1   2 , Zixuan Dou  3 , Aman Liu  1   2 , Jie Yu  4   5 , Boda Zhou  2
Affiliations

Association of Cancer with Heart Failure and the Prognostic Value of NT-proBNP in Cancer Patients: Findings from the NHANES (1999-2018)

Qingping Zeng et al. Curr Oncol. .

Abstract

Evidence regarding the association between cancer and heart failure (HF) is scarce. This study is to investigate the association between HF and cancer and explore the prognostic value of NT-proBNP in cancer patients. This cohort study used National Health and Nutrition Examination Survey data from 1999 to 2018 and linked mortality information until 2019. We included all participants with valid answer to questions regarding self-reported cancer and HF. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs. Our study included data from 54,847 adult participants. During a median (IQR) follow-up of 9.6 (4.0-15.1) years, 7674 deaths were recorded. HF was associated with an increased occurrence of cancer after propensity score matching (OR = 1.46, 95% CI: 1.17-1.82, p < 0.001). Cancer was associated with a higher occurrence of HF (OR = 1.33, 95% CI: 1.11-1.59, p = 0.002). Kaplan-Meier survival analysis over 10 years revealed the shortest survival in patients with both HF and cancer (log-rank p < 0.0001). Importantly, NT-proBNP was significantly higher in cancer patients, no matter whether with known HF (p < 0.01). In cancer patients without HF, NT-proBNP higher than 51.51 pg/mL was associated with shorter survival (log-rank p < 0.0001). Findings from this cohort study suggest that HF is significantly associated with cancer. NT-proBNP was higher in cancer patients, with significant prognostic value in cancer patients.

Keywords: NT-proBNP; cancer; heart failure; survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of participant inclusion.
Figure 2
Figure 2
Incidence rate of heart failure among all participants with/without cancer.
Figure 3
Figure 3
Comparison of NT-proBNP levels. (A). in participants without known HF, stratified by cancer status; (B). in participants with HF, stratified by cancer status; (C). in participants no matter whether they have known HF or not, stratified by cancer status; (D). across four patient groups categorized by the presence or absence of HF and cancer (CA).
Figure 4
Figure 4
Kaplan–Meier survival analysis. (A) in cancer participants without known HF according to NT-proBNP level; (B) across four patient groups categorized by the presence or absence of HF and cancer (CA).
See this image and copyright information in PMC

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