School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Curr Oncol. 2024 Aug 26;31(9):4927-4939. doi: 10.3390/curroncol31090365.
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, < 0.001). Cancer was associated with a higher occurrence of HF (OR = 1.33, 95% CI: 1.11-1.59, = 0.002). Kaplan-Meier survival analysis over 10 years revealed the shortest survival in patients with both HF and cancer (log-rank < 0.0001). Importantly, NT-proBNP was significantly higher in cancer patients, no matter whether with known HF ( < 0.01). In cancer patients without HF, NT-proBNP higher than 51.51 pg/mL was associated with shorter survival (log-rank < 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.
关于癌症和心力衰竭（HF）之间关联的证据很少。本研究旨在探讨 HF 与癌症之间的关联，并探索 NT-proBNP 在癌症患者中的预后价值。这项队列研究使用了 1999 年至 2018 年的国家健康和营养调查数据，并将死亡信息链接到 2019 年。我们纳入了所有对自我报告的癌症和 HF 问题有有效答案的参与者。多变量逻辑回归用于估计比值比（OR）和 95％置信区间（CI）。我们的研究包括 54847 名成年参与者的数据。在中位数（IQR）随访 9.6（4.0-15.1）年后，记录了 7674 例死亡。在倾向评分匹配后，HF 与癌症的发生增加相关（OR=1.46，95％CI：1.17-1.82， < 0.001）。癌症与 HF 的发生增加相关（OR=1.33，95％CI：1.11-1.59， = 0.002）。10 年的 Kaplan-Meier 生存分析显示，HF 和癌症并存的患者的生存时间最短（对数秩检验 < 0.0001）。重要的是，无论是否患有已知 HF，癌症患者的 NT-proBNP 均显著升高（ < 0.01）。在无 HF 的癌症患者中，NT-proBNP 高于 51.51 pg/mL 与较短的生存时间相关（对数秩检验 < 0.0001）。这项队列研究的结果表明，HF 与癌症显著相关。癌症患者的 NT-proBNP 较高，对癌症患者具有显著的预后价值。
