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Journal
2009 | 4 | 3 | 327-330
Article title

Cardiac troponin T for early detection of cardiotoxicity in breast cancer patients treated with epirubicin

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EN
Abstracts
EN
The aim of the study was to investigate the role of cTnT for the prediction of long term cardiac dysfunction after epirubicin-containing adjuvant chemotherapy for breast cancer. The study group comprised of 45 patients (all female; mean age 48 ±8 years), treated with epirubicin-containing adjuvant chemotherapy for stage 2 and stage 3 breast cancer. Patients received either 4 cycles of cyclophosphamide plus epirubicin (90 mg/m2) (n=23; stage 2 breast cancer) or 6 cycles of cyclophosphamide plus epirubicin (75 mg/m2) plus fluorouracil (n=18; stage 3 breast cancer). Venous blood samples were drawn, before and 72 hours after, every cycle of chemotherapy for the measurement of cTnT. Cardiac assessment was carried out at baseline and 1 year after chemotherapy by clinical evaluation, electrocardiography, radio-nuclide ventriculography (RNV) and transthoracic echocardiography. All patients remained free of clinical heart failure during the study period. In 26 patients (63%), cTnT was elevated after chemotherapy. Mean left ventricular ejection fraction, assessed by RNV at baseline and one year after chemotherapy, were 61±8% and 56±7% (p<0.0001). The sensitivity and specifity of cTnT for the detection of left ventricular systolic dysfunction at one year were 69% and 39% respectively. Echocardiographic examinations at baseline and one year after chemotherapy revealed a significant decrease in E/A ratio from 1.15±0.3 to 0.9±0.2 in cTnT positive patients, suggesting diastolic dysfunction. In conclusion, elevated serum cTnT levels after epirubicin-containing adjuvant chemotherapy for stage 2 and stage 3 breast cancer, predict future cardiac dysfunction with moderate sensitivity and poor specificity.
Publisher

Journal
Year
Volume
4
Issue
3
Pages
327-330
Physical description
Dates
published
1 - 9 - 2009
online
3 - 7 - 2009
Contributors
author
  • Florence Nightingale Hospital, 34119, Istanbul, Turkey
author
  • Marmara University Hospital, 34633, Istanbul, Turkey
author
  • Marmara University Hospital, 34633, Istanbul, Turkey
author
  • Marmara University Hospital, 34633, Istanbul, Turkey
author
  • Marmara University Hospital, 34633, Istanbul, Turkey
author
  • Marmara University Hospital, 34633, Istanbul, Turkey
author
  • Marmara University Hospital, 34633, Istanbul, Turkey
References
  • [1] Shan K., Lincoff A.M., Young J.B., Anthracycline-induced cardiotoxicity, Ann. Intern. Med., 1996, 125, 47–58
  • [2] Lipshultz S.E., Colan S.D., Gelber R.D., Perez-Atayde A.R., Sallan S.E., Sanders S.P., Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood, N. Engl. J. Med., 1991, 324, 808–15
  • [3] Scully R.E., Lipshultz S.E., Anthracycline cardiotoxicity in long-term survivors of childhood cancer, Cardiovasc. Toxicol., 2007, 7, 122–8 http://dx.doi.org/10.1007/s12012-007-0006-4[Crossref][WoS]
  • [4] Thomas X., Le Q.H., Fiere D., Anthracycline-related toxicity requiring cardiac transplantation in long-term disease-free survivors with acute promyelocytic leukemia, Ann. Hematol., 2002, 81, 504–7 http://dx.doi.org/10.1007/s00277-002-0534-8[Crossref]
  • [5] Gaze D.C., Collinson P.O., Cardiac troponins as biomarkers of drug- and toxin-induced cardiac toxicity and cardioprotection, Expert Opin. Drug. Metab. Toxicol., 2005, 1, 715–25 http://dx.doi.org/10.1517/17425255.1.4.715[Crossref]
  • [6] Cardinale D., Sandri M.T., Colombo A., Colombo N., Boeri M., Lamantia G., et al., Prognostic value of troponin I in cardiac risk stratification of cancer patients undergoing high-dose chemotherapy, Circulation, 2004, 109, 2749–54 http://dx.doi.org/10.1161/01.CIR.0000130926.51766.CC[Crossref]
  • [7] Kilickap S., Barista I., Akgul E., Aytemir K., Aksoyek S., Aksoy S., et al., cTnT can be a useful marker for early detection of anthracycline cardiotoxicity, Ann. Oncol., 2005, 16, 798–804 http://dx.doi.org/10.1093/annonc/mdi152[Crossref]
  • [8] Arcamone F., Properties of antitumor anthracyclines and new developments in their application: Cain memorial award lecture., Cancer Res., 1985, 45, 5995–9
  • [9] Glück S., Adjuvant chemotherapy for early breast cancer: optimal use of epirubicin, Oncologist, 2005, 10, 780–91 http://dx.doi.org/10.1634/theoncologist.10-10-780[Crossref]
  • [10] Early Breast Cancer Trialists’ Collaborative Group. Polychemotherapy for early breast cancer: an overview of the randomised trials, Lancet, 1998, 352, 930–942 http://dx.doi.org/10.1016/S0140-6736(98)03301-7[Crossref]
  • [11] Levine M.N., Whelan T., Adjuvant chemotherapy for breast cancer-30 years later, N. Engl. J. Med., 2006, 355, 1920–2 http://dx.doi.org/10.1056/NEJMe068204
  • [12] Meinardi M.T., van der Graaf W.T., van Veldhuisen D.J., Gietema J.A., de Vries E.G., Sleijfer D.T., Detection of anthracycline-induced cardiotoxicity, Cancer Treat. Rev., 1999, 25, 237–47 http://dx.doi.org/10.1053/ctrv.1999.0128[Crossref]
  • [13] Jannazzo A., Hoffman J., Lutz M., Monitoring of anthracycline-induced cardiotoxicity, Ann. Pharmacother., 2008, 42, 99–104 [WoS]
  • [14] Jones R.L., Miles D.W., Use of endomyocardial biopsy to assess anthracycline-induced cardiotoxicity, Lancet Oncol., 2005, 6, 67 http://dx.doi.org/10.1016/S1470-2045(05)01719-5[Crossref]
  • [15] Vogelsang T.W., Jensen R.J., Hesse B., Kjaer A., BNP cannot replace gated equilibrium radionuclide ventriculography in monitoring of anthracycline-induced cardiotoxity, Int. J. Cardiol., 2008, 124, 193–7 http://dx.doi.org/10.1016/j.ijcard.2007.02.003[Crossref][WoS]
  • [16] Cheitlin M.D., Armstrong W.F., Aurigemma G.P., Beller G.A., Bierman F.Z., Davis J.L., et al.,; ACC; AHA; ASE. ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography), J. Am. Soc. Echocardiogr., 2003, 16, 1091–110
  • [17] Bu’Lock F.A., Mott M.G., Oakhill A., Martin R.P., Left ventricular diastolic function after anthracycline chemotherapy in childhood: relation with systolic function, symptoms, and pathophysiology, Br. Heart J., 1995, 73, 340–50 http://dx.doi.org/10.1136/hrt.73.4.340[Crossref]
  • [18] Dorup I., Levitt G., Sullivan I., Sorensen K., Prospective longitudinal assessment of late anthracycline cardiotoxicity after childhood cancer: the role of diastolic function, Heart, 2004, 90, 1214–6 http://dx.doi.org/10.1136/hrt.2003.027516[Crossref]
  • [19] Erkus B., Demirtas S., Yarpuzlu A.A., Can M., Genc Y., Karaca L., Early prediction of anthracycline induced cardiotoxicity, Acta Paediatr., 2007, 96, 506–9 http://dx.doi.org/10.1111/j.1651-2227.2006.00174.x[WoS][Crossref]
  • [20] Specchia G., Buquicchio C., Pansini N., Di Serio F., Liso V., Pastore D., et al., Monitoring of cardiac function on the basis of serum troponin I levels in patients with acute leukemia treated with anthracyclines. J. Lab. Clin. Med., 2005, 145, 212–20 http://dx.doi.org/10.1016/j.lab.2005.02.003[Crossref]
  • [21] Nisticò C., Bria E., Cuppone F., Carpino A., Ferretti G., Vitelli G., et al., Troponin-T and myoglobin plus echocardiographic evaluation for monitoring early cardiotoxicity of weekly epirubicin-paclitaxel in metastatic breast cancer patients, Anticancer Drugs., 2007, 18, 227–32 http://dx.doi.org/10.1097/CAD.0b013e328011335e[Crossref]
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_s11536-008-0093-z
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