Abstract
BackgroundPatients with lung cancer are at increased risk for the development of cardiovascular diseases. Molecular markers for early diagnosis of cardiac ischemia are of great significance for the early prevention of cardiovascular events in patients with lung cancer. By evaluating the relationship between adrenomedullin (ADM) and myocardial ischemic T wave changes, the clinical value of circulating ADM as a predictor of myocardial ischemia in patients with lung cancer is confirmed.MethodsWe enrolled patients with lung cancer and healthy people from 2019 to 2021 and extracted a detailed ECG parameter. After adjustment for potential confounders, logistic regression was used to assess the association of clinical data. We performed analyses on differences in T wave between patients with lung cancer and healthy people, and the relationship between T wave and ADM among patients with lung cancer. Receiver operator characteristic (ROC) curves were drawn to confirm the diagnostic value of biomarkers.ResultsAfter adjusting for potential confounders, the incidence of T wave inversion or flattening in patients with lung cancer was higher than in healthy people (OR: 3.3228, P = 0.02). Also, further analysis of the data of lung cancer patients revealed that the ADM in lung cancer patients with T wave inversion or flat was higher than those with normal T wave (189.8 ± 51.9 vs. 131.9 ± 38.4, p < 0.001). The area under the ROC curve was 0.8137.ConclusionAmong the patients with lung cancer, serum ADM concentration is associated with the incidence of the abnormal T wave. ADM might be a potentially valuable predictor for heart ischemia in patients with lung cancer.
Highlights
Cancer and cardiovascular diseases (CVDs) are two major killers among humans across the world
The rate of occurrence of T wave inversion or flattening in patients with lung cancer was higher than that in the healthy control population (23.9% vs. 11%, p = 0.036), and smokers among them were markedly more than healthy subjects (44.8% vs. 8.5%, p < 0.001)
By using logistics regression analysis, we adjusted for influencing factors including gender, age, history of cardiovascular and cerebrovascular diseases, lifestyle risk factors, and history of related drug therapy; the results indicated an independent positive association between serum ADM level and myocardial ischemia-related ECG change (T wave inversion or flattening) among the patients with lung cancer
Summary
Cancer and cardiovascular diseases (CVDs) are two major killers among humans across the world. Recent data have indicated that CVDs have become a leading cause of morbidity and mortality among cancer survivors [2] This is largely because of tumor invasiveness (like direct compression or infiltration and several inflammatory factors) and cancer treatment-related cardiotoxicity [3]. A lung tumor releases pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, and IFN-γ), chemokines, and soluble factors into the blood These substances are returned to the heart via pulmonary circulation and directly elicit catabolic responses in the heart [6, 7]. Platinum-based chemotherapy, microtubular agents, ALK inhibitors, endothelial growth factor receptor (EGFR) inhibitors, and immunotherapy represent principal clinical options for lung cancer therapy [9–11]. All of these drugs have been shown to result in cardiotoxicity. By evaluating the relationship between adrenomedullin (ADM) and myocardial ischemic T wave changes, the clinical value of circulating ADM as a predictor of myocardial ischemia in patients with lung cancer is confirmed
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