August 2025
Cardiac biomarkers may predict future cancer risk
By Rebecca Jenkins
A study finding two cardiac blood markers can strongly predict future cancer risk highlights the growing understanding of the two-way relationship between cardiovascular disease and cancer, an Australian expert says.
The US research, published in the Journal of the American College of Cardiology: Advances, found higher baseline levels of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) were strong predictors of an increased risk of incident cancer events, with no significant differences between sex and ethnicity.
Researchers used data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, which included 6244 non-Hispanic White, Black, Hispanic/Latino and Chinese men and women (52.7% female) with a median age of 61 years, who were free of CVD and self-reported cancer at baseline.
Over a median follow up of 17.8 years, there were 820 incident cancer events, with an incidence rate of 91.2 cases per 10,000 person-years.
Looking at specific cancers, baseline levels of both biomarkers were associated with an increased risk of colorectal cancer, whereas only NT-proBNP was linked with lung cancer, the researchers reported.
However, none of the sex-specific cancers were associated with baseline levels of the two cardiac biomarkers.
Welcoming the findings, Dr Faisal Hayat, Staff Specialist in Medical Oncology at the Calvary Mater Newcastle, said historically the field of cardio-oncology had focused on managing the heart-related side effects of cancer treatments; however, in recent years, there had been a significant shift in thinking.
‘This study is a great example of how the field is expanding – we’re learning that the same risk factors, such as lifestyle, chronic inflammation and genetics, can drive both heart disease and cancer,’ he told Medicine Today.
Dr Hayat, who is about to undertake a PhD in cardio-oncology, said the association found in the US research was biologically plausible, with chronic inflammation and oxidative stress potentially leading to subtle heart damage detectable by these biomarkers, as well as playing a role in the development of cancer.
‘What we are seeing here is likely not a case of these biomarkers directly leading to a cancer diagnosis, but rather a reflection of the patient’s overall health,’ he said.
However, other studies had shown that even mild heart stress could result in the release of signalling molecules in the bloodstream that might promote cancer growth, while undiagnosed cancers could also cause a mild increase in these cardiac markers.
‘These findings highlight that the relationship between the heart and cancer is complex and interconnected in ways that we are only beginning to understand,’ Dr Hayat said.
Further research was needed before cardiac biomarkers could potentially be used as part of cancer screening, Dr Hayat stressed. However, it was hoped a better understanding of how the biology of the heart and cancer might be deeply intertwined would lead to improved early detection and prevention strategies for both conditions.
‘The goal of cardio-oncology is no longer just to react to problems as they arise, but to anticipate risks, personalise care and ultimately improve patient outcomes,’ Dr Hayat said.