NTproBNP as an independent predictor of all-cause mortality in elderly cancer patients

Introduction Cardiac biomarkers are well-established predictors of cardiotoxicity. However, their role in predicting mortality among elderly cancer patients receiving antineoplastic therapy remains unclear. This study aimed to analyze all-cause mortality and its predictors in elderly patients. Materials and Methods A prospective, observational, longitudinal, and non-interventional study was conducted. The cohort included 110 elderly cancer patients aged ≥65 years, monitored for cardiovascular parameters during and after oncological treatment. Data on epidemiological variables, cardiovascular risk factors (CVRFs), cardiac history, cancer type and treatment, cardiac biomarkers, and imaging parameters were analyzed. Statistical analysis was performed using SPSS version 25. Results The median age of the patients was 73 years (67–78), with the majority (75.5%) diagnosed with solid tumors. Most patients (83.4%) had at least one CVRF (hypertension 61%, dyslipidemia 44%, diabetes mellitus 25.5%), and over half had poorly controlled or newly diagnosed CVRFs. After a median follow-up of 5.3 years (1.3; 8.1), 65 patients (59%) died, mostly related with oncology disease (74%), and 36% experienced clinical cardiovascular events, with clinical heart failure being the most common (16%). Patients with elevated baseline NTproBNP levels had nearly nine times the risk of mortality compared to those with normal levels (Log Rank: 8.98, p = 0.03). All NTproBNP values recorded during monitoring were significantly associated with increased mortality. After adjusting for age, gender, CVRFs, cardiovascular history, and basal left ventricular ejection fraction, multivariate Cox regression identified baseline NTproBNP levels (hazard ratio [HR]: 1.0; 95% CI: 1.00–1.001; p = 0.022) and metastatic disease (HR: 3.3; 95% CI: 1.96–5.5; p < 0.001) as independent predictors of mortality. Elevated baseline hs-troponin T showed a statistical trend (HR: 1.042; 95% CI: 0.997–1.088; p = 0.068). Conclusion Baseline NTproBNP levels are an independent predictor of all-cause mortality in elderly cancer patients. Their measurement offers significant value for risk stratification and could guide personalized management strategies in this high-risk population of older adults.Kaplan Meier Curve Survival Multivariante analysis. Cox regresion