Baseline Cardiac Biomarker Levels as Predictors of Cancer Risk in the MESA Cohort

Abstract

Background

Assessing the association between baseline levels of cardiac biomarkers and future cancer risk is critical to understand the cross talk between cardiovascular disease and cancer.

Objectives

The authors aimed to determine the association between baseline levels of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) with cancer risk in the prospective MESA (Multi-Ethnic Study of Atherosclerosis) cohort.

Methods

We analyzed data from 6,244 MESA participants free of self-reported cancer and cardiovascular disease at baseline. Incident cancer was identified using International Classification of Diseases-9th Revision codes from hospitalizations. Cox proportional hazards models were employed to evaluate the associations of hs-cTnT and NT-proBNP with cancer risk. Likelihood ratio tests assessed whether these associations differed by race/ethnicity or sex.

Results

The median age was 61.0 years, with 52.7% being female. Over a median follow-up period of 17.8 years, there were 820 incident cancer events, with an incidence rate of 91.2 cases per 10,000 person-years. Higher incidence rates for all cancers were generally associated with higher baseline hs-cTnT and NT-proBNP levels, especially in the highest quartiles. For all-cancer endpoints, the HRs of hs-cTnT and NT-proBNP, calculated based on the SDs for continuous covariates after standardization, were statistically significant in fully adjusted models (HR: 1.18; 95% CI: 1.09-1.27; P < 0.001; and HR: 2.41; 95% CI: 1.30-4.49; P = 0.006, respectively). Sex and race/ethnicity did not significantly affect any of these associations.

Conclusions

In the MESA cohort, higher baseline levels of hs-cTnT and NT-proBNP predicted an increased risk of incident cancer, with no significant differences by race/ethnicity or sex.