van den Berg, P.F. (2020) The Heart of the Matter: A Three-way Analysis of 92 Tumorassociated Biomarkers in Heart Failure. thesis, Medicine.
Full text available on request.Abstract
Background. Heart failure (HF) stimulates tumor growth through circulating factors, leading to an increased risk of cancer death. The underlying pathophysiology is poorly understood, and it is unknown whether these circulating factors reflect the severity of HF. Objectives. To determine the role of 92 tumor-associated biomarkers in HF patients and investigate to what extent these biomarkers are associated with the composite outcome of HF (re)hospitalization and death. Methods. We measured 92 tumor-associated biomarkers in 2035 patients with HF from the BIOSTAT-CHF cohort. Using process overrepresentation, Cox-, logistic regressions and cluster analyses, we identified putative oncogenic pathophysiological processes associated with a composite outcome of HF (re)hospitalization and death in patients with HF. Statistical analyses were performed with STATASE16 (StataCorp LP, College Station, TX, USA) and R (Foundation for Statistical Computing, Vienna, Austria). Results. In total, we identified 307 pathophysiological processes. Of these, eight were associated with adverse events after correction for multiple testing. Positive regulation of chemotaxis (HR 2.60, 95% CI 1.18-5.71, p=0.016) and regulation of adaptive immune response (HR 1.53, 95% CI 1.08-2.19, p=0.016) showed the strongest association with the composite outcome. Within these processes, CD48 (HR 1.55, 95% CI 1.14-2.09, p=0.005) and TNFSF13 (HR 1.40, 95% CI 1.09-1.81, p=0.009) showed a strong and independent association with the composite outcome. Conclusion. Positive regulation of chemotaxis and regulation of adaptive immune response are oncogenic processes also associated with adverse outcomes in HF. CD48 and TNFSF13 are key markers within these processes. These data highlight the importance of oncogenic processes in HF (outcomes).
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | de Boer, Prof. Dr. R.A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 16 Aug 2023 11:29 |
| Last Modified: | 16 Aug 2023 11:29 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3631 |
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