Elevated blood levels of NT-proBNP in cancer survivors link with higher risks of death

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Study Title: Elevated blood levels of NT-proBNP in cancer survivors link with higher risks of death

Publication: Journal of the National Cancer Institute

Dana-Farber Cancer Institute authors: Chao Cao, PhD, MPH, first author; Jennifer Ligibel, MD, senior author; Erica Mayer, MD, MPH; and Ann Partridge, MD, MPH.


Cancer survivors with elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) have a higher risk of death, an analysis of data from a US nationally representative sample shows. NT-proBNP is produced in response to the stretching of muscle cells called myocytes in the heart ventricles. It is a biomarker of myocarditis (inflammation of a layer of heart muscle) and cancer treatment-related heart damage that can be traced in the blood. In the current study, researchers compared NT-proBNP levels in 787 cancer survivors and 12,574 adults never diagnosed with cancer from the US National Health and Nutrition Examination Survey study. They found that the cancer survivors had higher levels of NT-proBNP than non-cancer adults after adjusting for the influence of sociodemographic characteristics, lifestyle factors and chronic conditions. The higher levels of NT-proBNP were particularly evident in survivors of breast, prostate, or colorectal cancer. During a median follow-up of 13.4 years, cancer survivors with high NT-proBNP had a statistically higher risk of death from any cause and death from cardiovascular disease but not death due to cancer compared to survivors with low NT-proBNP. This study highlights the potential of using NT-proBNP for cardiovascular disease risk screening in cancer survivors to identify a group of individuals who might benefit from cardioprotective strategies.


Higher blood levels of NT-proBNP – a marker of heart inflammation and heart failure – were associated with a higher risk of cardiovascular mortality in cancer survivors. The findings suggest NT-proBNP could be a tool for monitoring cardiovascular health in cancer survivors across malignancies.


National Cancer Institute (grant 5T32CA092203)

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Chao Cao, PhD, MPH


Jennifer Ligibel, MD