Key result
Tamoxifen after chemotherapy is linked to ~73% lower NT-proBNP and better-preserved LVEF.
Why the study?
Does hormone therapy with tamoxifen after chemotherapy reduce plasma NT-proBNP levels and preserve left ventricular ejection fraction in women with early-stage breast cancer?
Cohort (n=60)
No
Does hormone therapy with tamoxifen after chemotherapy reduce plasma NT-proBNP levels and preserve left ventricular ejection fraction in women with early-stage breast cancer?
Answers are grounded in this paper and cite their sources.
Adjuvant tamoxifen therapy for 6 months following anthracycline-based chemotherapy reverses chemotherapy-induced elevations in NT-proBNP and prevents decline in LVEF at 12 months in women with breast cancer.
The objective of this study was to evaluate the effect of tamoxifen on the plasma concentration of NT-pro-B-type natriuretic peptide (NT-proBNP) in women undergoing chemotherapy for breast cancer and to correlate changes in NT-proBNP with the left ventricular ejection fraction (LVEF). Over a period of 12 months, we followed 60 women with a diagnosis of breast cancer. The patients were separated into a group that received only chemotherapy (n=23), a group that received chemotherapy + tamoxifen (n=21), and a group that received only tamoxifen (n=16). Plasma levels of NT-proBNP were assessed at 0 (T0), 6 (T6), and 12 (T12) months of treatment, and echocardiography data were assessed at T0 and T12. Plasma NT-proBNP levels were increased in the chemotherapy-only group at T6 and T12, whereas elevated NT-proBNP levels were only found at T6 in the chemotherapy + tamoxifen group. At T12, the chemotherapy + tamoxifen group exhibited a significant reduction in the peptide to levels similar to the group that received tamoxifen alone. The chemotherapy-only group exhibited a significant decrease in LVEF at T12, whereas the chemotherapy + tamoxifen and tamoxifen-only groups maintained levels similar to those at the beginning of treatment. Treatment with tamoxifen for 6 months after chemotherapy significantly reduced the plasma levels of NT-proBNP and did not change LVEF in women with breast cancer.
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Silva et al. (2014) conducted a cohort in Early-stage breast cancer without metastases (n=60). Chemotherapy followed by tamoxifen hydrochloride vs. Chemotherapy alone (6 months) or tamoxifen alone (12 months) was evaluated on Plasma NT-proBNP concentration (pg/mL) and left ventricular ejection fraction (LVEF, %) at 12 months (p=<0.01). Tamoxifen for 6 months after chemotherapy reduced 12-month plasma NT-proBNP (11.39 vs 42.35 pg/mL, P<0.01) and preserved LVEF (76.2% vs 63.3%, P<0.01) compared to chemotherapy alone.
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