Acute dyspnoea in cancer patients: Prevalence of acute heart failure, resource use and diagnostic accuracy of natriuretic peptides.
Publisher DOI
PubMed ID
40583498
Abstract
Aims
Among cancer patients presenting with acute dyspnoea, the prevalence of acute heart failure (AHF), resource use and diagnostic accuracy of natriuretic peptides remain unknown. This study aimed to address these knowledge gaps.
Methods And Results
Patients presenting with acute dyspnoea to the emergency department (ED) were prospectively enrolled in a multicentre diagnostic study. AHF was centrally adjudicated by two independent cardiologists based on current guidelines. B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) concentrations were measured at ED presentation. Cancer status, resource use, and long-term outcomes were prospectively assessed. Among 2153 patients, 473 (22.0%) had an active or past cancer. AHF was the most common final diagnosis in both cancer and non-cancer patients (44.4% vs. 51.0%, p = 0.01). Among the alternative diagnoses, pneumonia and cancer-related dyspnoea were more frequent in patients with cancer, while anxiety disorder/hyperventilation was frequent in patients without cancer. Hospitalization rate and length of hospital stay were both higher in cancer patients (p < 0.01). Among AHF-related signs, rales and pleural effusion showed a significant interaction with cancer status and had lower diagnostic accuracy in cancer patients. The area under the curve (AUC) of NT-proBNP was lower in cancer than in non-cancer patients (0.89 vs. 0.93, p = 0.01), while that of BNP was similar (0.93 vs. 0.95, p = ns). This difference was mainly due to active cancers.
Conclusions
Acute heart failure was the most common diagnosis in cancer patients presenting with acute dyspnoea. Rales, pleural effusion, and NT-proBNP had lower diagnostic accuracy versus patients without cancer, while that of BNP remained robust.
Among cancer patients presenting with acute dyspnoea, the prevalence of acute heart failure (AHF), resource use and diagnostic accuracy of natriuretic peptides remain unknown. This study aimed to address these knowledge gaps.
Methods And Results
Patients presenting with acute dyspnoea to the emergency department (ED) were prospectively enrolled in a multicentre diagnostic study. AHF was centrally adjudicated by two independent cardiologists based on current guidelines. B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) concentrations were measured at ED presentation. Cancer status, resource use, and long-term outcomes were prospectively assessed. Among 2153 patients, 473 (22.0%) had an active or past cancer. AHF was the most common final diagnosis in both cancer and non-cancer patients (44.4% vs. 51.0%, p = 0.01). Among the alternative diagnoses, pneumonia and cancer-related dyspnoea were more frequent in patients with cancer, while anxiety disorder/hyperventilation was frequent in patients without cancer. Hospitalization rate and length of hospital stay were both higher in cancer patients (p < 0.01). Among AHF-related signs, rales and pleural effusion showed a significant interaction with cancer status and had lower diagnostic accuracy in cancer patients. The area under the curve (AUC) of NT-proBNP was lower in cancer than in non-cancer patients (0.89 vs. 0.93, p = 0.01), while that of BNP was similar (0.93 vs. 0.95, p = ns). This difference was mainly due to active cancers.
Conclusions
Acute heart failure was the most common diagnosis in cancer patients presenting with acute dyspnoea. Rales, pleural effusion, and NT-proBNP had lower diagnostic accuracy versus patients without cancer, while that of BNP remained robust.
Date Issued
2025-11
Publication Type
Article
Subject(s)
Subjects
Acute heart failure
•
Biomarkers
•
Cancer survivorship
•
Diagnosis
•
Natriuretic peptides
Language(s)
en
Author(s)
Bima, Paolo | |
Wussler, Desirée | |
Lopez-Ayala, Pedro | |
Belkin, Maria | |
Lin, Xueting | |
Strebel, Ivo | |
Sgueglia, Fabiana | |
Michou, Eleni | |
Papachristou, Androniki | |
Popescu, Codruta | |
Shrestha, Samyut | |
Kuster, Gabriela | |
Rentsch, Katharina | |
Von Eckardstein, Arnold | |
Binder, Mascha | |
Mahfoud, Felix | |
Breidthardt, Tobias | |
Mueller, Christian |
Additional Credits
Journal
European Journal of Heart Failure
Publisher
Wiley
ISSN
1879-0844
1388-9842
Access(Rights)
Unknown