Are Biomarkers Predictive of Anthracycline-Induced Cardiac Dysfunction?

Malik, Abhidha; Jeyaraj, Pamela Alice; Calton, Rajneesh; Uppal, Bharti; Negi, Preety; Shankar, Abhishek; Patil, Jaineet; Mahajan, Manmohan Kishan

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자료유형: 학술저널

저자정보: Malik, Abhidha (Department of Radiation Oncology, Dr B.R.A Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences) Jeyaraj, Pamela Alice (Department of Radiation Oncology, Christian Medical College and Hospital) Calton, Rajneesh (Department of Cardiology, Christian Medical College and Hospital) Uppal, Bharti (Department of Biochemistry, Christian Medical College and Hospital) Negi, Preety (Department of Radiation Oncology, Christian Medical College and Hospital) Shankar, Abhishek (Department of Radiation Oncology, Dr B.R.A Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences) Patil, Jaineet (Department of Radiation Oncology, Christian Medical College and Hospital) Mahajan, Manmohan Kishan (Department of Radiation Oncology, Christian Medical College and Hospital)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제17권 제4호

발행연도: 2016.1

수록면: 2,301 - 2,305 (5page)

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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 $0.154{\pm}0.433cms$ (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 ${\leq}0.0001$) 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.

#Anthracycline #breast cancer #cardiotoxicity

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Malik, Abhidha

소속기관 Department of Radiation Oncology, Dr B.R.A Institute of Rotary Cancer Hospital, All India Institute