Evaluation of anthracycline-induced cardiotoxicity using cardiac biomarkers: A prospective study.

Abstract

Background: Though anthracyclines are the commonly used chemotherapeutics for cancer treatment, close monitoring of patients is required due to its well reported cardiotoxicity. The present study evaluates the role of biomarkers [N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin-T (hs-cTnT)] in early prediction of cardiotoxicity in patients with breast and ovarian cancer who received anthracyclines.

Methods: This was a single-center observational study conducted between August-2018 and January-2020. Doxorubicin was used as an anthracycline at a dose of 50 mg/m2 per cycle. All the patients underwent echocardiography before the start and at 3 months, 6 months and 12 months after chemotherapy. NT-proBNP and hs-cTnT levels were measured before as baseline and within 24 hours of the first and last cycle of anthracycline-based chemotherapy.

Results: A total of 72 patients with breast and ovarian cancer participated in the study. The mean age of patients was 49.4 ± 10.3 years. Sixty six (91.7%) patients had breast cancer and 9 (12.5%) patients developed cardiotoxicity. Mean age of the patients who developed cardiotoxicity was 55.00 ± 12.5 years. The level of NT-proBNP and hs-cTnT were significantly increased after the last cycle of anthracycline in patients who developed cardiotoxicity.

Conclusion: The measurement of NT-proBNP and hs-cTnT levels after anthracycline administration helps detect early sub-clinical cardiotoxicity and thus can assist in modification of therapeutic regimens and initiation of heart failure therapy to prevent future cardiac events.