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Are Biomarkers Predictive of Anthracycline-Induced Cardiac Dysfunction?
- Source :
- Asian Pacific Journal of Cancer Prevention. 17:2301-2305
- Publication Year :
- 2016
- Publisher :
- Asian Pacific Organization for Cancer Prevention, 2016.
-
Abstract
- Background The early detection of anthracycline- induced cardiotoxicity is very important since it might be useful in prevention of cardiac decompensation. This study was designed with the intent of assessing the usefulness of cardiac troponin T (cTnT) and NT- Pro BNP estimation in early prediction of anthracycline induced cardiotoxicity. Materials and methods In this prospective study histologically proven breast cancer patients who were scheduled to receive anthracycline containing combination chemotherapy as a part of multimodality treatment were enrolled. Baseline cardiac evaluation was performed by echocardiography (ECHO) and biomarkers like cardiac troponin T (cTnT) and N terminal- pro brain natriuretic peptide (NT- Pro BNP). All patients underwent cTnT and NT- Pro BNP estimation within 24 hours of each cycle of chemotherapy and were followed up after 6 months of initiation of chemotherapy. Any changes in follow up ECHO were compared to ECHO at baseline and cTnT and NT- Pro BNP levels after each cycle of anthracycline-based chemotherapy. Results Initial data were obtained for 33 patients. Mean change in left ventricular diastolic diameter (LVDD) within 6 months was 0.154± 0 .433 cms (p value=0.049). Seven out of 33 patients had an increase in biomarker cTnT levels (p value=0.5). A significant change in baseline and follow up LVDD was observed in patients with raised cTnT levels (p value=0.026) whereas no change was seen in ejection fraction (EF) and left atrial diameters (LAD) within 6 months of chemotherapy. NT- Pro BNP levels increased in significant number of patients (p value ≤0.0001) but no statistically significant change was observed in the ECHO parameters within 6 months. Conclusions Functional monitoring is a poorly effective method in early estimation of anthracycline induced cardiac dysfunction. Estimation of biomarkers after chemotherapy may allow stratification of patients in various risk groups, thereby opening window for interventional strategies in order to prevent permanent damage to the myocardium.
- Subjects :
- Adult
Cancer Research
medicine.medical_specialty
Anthracycline
Epidemiology
medicine.drug_class
Diastole
Breast Neoplasms
030204 cardiovascular system & hematology
Cardiotoxins
Ventricular Dysfunction, Left
03 medical and health sciences
0302 clinical medicine
Troponin T
Troponin complex
Internal medicine
Natriuretic Peptide, Brain
Natriuretic peptide
medicine
Humans
Anthracyclines
Prospective Studies
Aged
Neoplasm Staging
Cardiotoxicity
Ejection fraction
business.industry
Public Health, Environmental and Occupational Health
Combination chemotherapy
Middle Aged
Prognosis
Echocardiography, Doppler
Peptide Fragments
Early Diagnosis
Oncology
030220 oncology & carcinogenesis
Cardiology
Female
business
Biomarkers
Follow-Up Studies
Subjects
Details
- ISSN :
- 15137368
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Asian Pacific Journal of Cancer Prevention
- Accession number :
- edsair.doi.dedup.....7391bebe0ccb1bc5d7a6c199fc36227c