Key result
Persistent NT-proBNP elevation during not-high-dose anthracycline chemotherapy was significantly correlated with left ventricular ejection fraction reduction at 12 months (p=0.013).
Why the study?
Do serial measurements of NT-proBNP predict late left ventricular impairment in breast cancer patients treated with not-high-dose anthracycline chemotherapy?
Observational (n=71)
Echocardiogram assessors blinded
No
Do serial measurements of NT-proBNP predict late left ventricular impairment in breast cancer patients treated with not-high-dose anthracycline chemotherapy?
Serial NT-proBNP measurements, specifically a baseline-to-peak increase of >36%, can predict late left ventricular impairment in breast cancer patients receiving standard-dose anthracyclines.
Elevated NT-proBNP may flag late LV impairment risk after NHDC; leaves open routine use pending randomized validation.
BACKGROUND: The aim of this study was to assess the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting late cardiotoxicity in patients treated with not-high-dose chemotherapy (NHDC), and to compare the predictive value of NT-proBNP and cardiac troponin I (cTnI). METHODS: In 71 patients undergoing NHDC with anthracyclines, NT-proBNP and cTnI levels were measured before and 24 h after each NHDC cycle. Left ventricular (LV) function was assessed by echocardiography at baseline, every two NHDC cycles, at the end of chemotherapy, and at 3-, 6- and 12-month follow-up. RESULTS: During NHDC, only NT-proBNP showed abnormal values. According to NT-proBNP behaviour, patients were divided into two groups: group A (n=50) with normal (n=23) or transiently elevated NT-proBNP levels (n=27), and group B (n=21) with persistently elevated NT-proBNP levels. At follow-up, LV impairment was significantly worse in group B than in group A. %Δ (baseline-peak) NT-proBNP was predictive of LV impairment at 3-, 6- and 12-month follow-up, with a cutoff of 36%. CONCLUSION: Serial measurements of NT-proBNP may be a useful tool for the early detection of patients treated with NHDC at high risk of developing cardiotoxicity.
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Romano et al. (2011) conducted an observational in Breast cancer undergoing not-high-dose anthracycline chemotherapy (n=71). Persistent NT-proBNP elevation vs. Normal or transiently elevated NT-proBNP was evaluated on Prediction of left ventricular impairment at 12-month follow-up (AUC 0.77, 95% CI 0.66-0.86). Persistent NT-proBNP elevation during not-high-dose anthracycline chemotherapy was significantly correlated with left ventricular ejection fraction reduction at 12 months (p=0.013).
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