Key result
Early troponin elevation in breast cancer patients receiving chemotherapy was not significantly associated with subsequent cardiac dysfunction (OR 3.40; 95% CI 0.69-16.67; p=0.13).
Why the study?
Chemotherapy-induced cardiotoxicity is a serious complication in breast cancer treatment, and the association between early elevations of cardiac biomarkers and subsequent cardiac dysfunction requires evaluation.
Do early elevations of cardiac markers (troponin and NT-proBNP) predict the development of chemotherapy-induced cardiotoxicity in adult patients with breast cancer?
Meta-Analysis
Do early elevations of cardiac markers (troponin and NT-proBNP) predict the development of chemotherapy-induced cardiotoxicity in adult patients with breast cancer?
Odds Ratio: 3.4 (95% CI 0.69–16.67)
p-value: p=0.13
Early troponin elevation shows a trend toward predicting cancer therapy-related cardiac dysfunction in breast cancer patients, but the association was not statistically significant due to high heterogeneity, warranting further prospective validation.
Precludes routine reliance on early biomarker elevations to predict breast cancer cardiotoxicity; leaves open whether standardized.
Background/Objectives: Chemotherapy-induced cardiotoxicity is a serious complication in breast cancer treatment, particularly with anthracyclines and HER2-targeted therapy. To evaluate the association between early elevations of cardiac markers (troponin and NT-proBNP) and the development of chemotherapy-induced cardiotoxicity in adult patients with breast cancer. Methods: This systematic review and meta-analysis were conducted according to PRISMA guidelines and registered with PROSPERO (CRD420261301170). A systematic search of PubMed/MEDLINE, Cochrane CENTRAL, and Web of Science databases was conducted. Studies evaluating cardiac markers in breast cancer patients receiving chemotherapy were included in the review. Results: Fourteen studies were included in the qualitative synthesis. Five studies were included in the meta-analysis. Elevated troponin levels were associated with higher odds of subsequent cardiac dysfunction; however, the pooled association was not statistically significant [OR = 3.40, 95% CI 0.69–16.67, p = 0.13] and showed substantial heterogeneity [I2 = 86.97%]. A leave-one-out sensitivity analysis was used to identify a study that exerted a substantial influence; its exclusion eliminated between-group heterogeneity and attenuated the pooled effect estimate. Conclusions: Early troponin elevation may provide a biological signal of myocardial injury during cancer therapy. However, the association between elevated troponin level and cancer therapy-related cardiac dysfunction did not reach the threshold of statistical significance and showed substantial heterogeneity. Troponin and NT-proBNP may provide complementary information to cardiac imaging, but their predictive performance and clinical utility require further prospective validation.
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Askambayeva et al. (2026) conducted a meta-analysis in Breast cancer receiving chemotherapy. Early elevation of troponin and NT-proBNP vs. Normal or non-elevated cardiac markers was evaluated on Subsequent cancer therapy-related cardiac dysfunction (OR 3.40, 95% CI 0.69-16.67, p=0.13). Early troponin elevation in breast cancer patients receiving chemotherapy was not significantly associated with subsequent cardiac dysfunction (OR 3.40; 95% CI 0.69-16.67; p=0.13).
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