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High-sensitivity troponin T as a marker to predict cardiotoxicity in breast cancer patients with adjuvant trastuzumab therapy.

Katsurada K, Ichida M, Sakuragi M, Takehara M, Hozumi Y, Kario K - Springerplus (2014)

Bottom Line: We divided the patients into two groups: group R was the nine patients who showed a reduction of left ventricular ejection fraction (LVEF) ≥5%, and group N was the 10 patients who showed a reduction of LVEF <5%.The high-sensitivity troponin T (hs-TnT) level at 6 months was significantly higher in group R than in group N (11.0 ± 7.8 pg/mL vs. 4.0 ± 1.4 pg/mL, p < 0.01).The hs-TnT level with a cutoff value of 5.5 pg/mL at 6 months had 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan.

ABSTRACT
The humanized monoclonal antibody trastuzumab has been in routine use for chemotherapy for human epidermal growth factor receptor II (HER2)-positive breast cancer. A major adverse effect of trastuzumab is cardiotoxicity. Well-established biomarkers or echocardiographic parameters to predict trastuzumab-induced cardiotoxicity have not yet been determined. We attempted to identify useful biomarkers and/or echocardiographic parameters to predict trastuzumab-induced cardiotoxicity. We prospectively investigated the cases of 19 women who received chemotherapy including anthracyclines and trastuzumab for HER2-positive breast cancer. We measured cardiac biomarkers and echocardiographic parameters before their chemotherapy and every 3 months up to 15 months until the end of the adjuvant trastuzumab therapy. We divided the patients into two groups: group R was the nine patients who showed a reduction of left ventricular ejection fraction (LVEF) ≥5%, and group N was the 10 patients who showed a reduction of LVEF <5%. The high-sensitivity troponin T (hs-TnT) level at 6 months was significantly higher in group R than in group N (11.0 ± 7.8 pg/mL vs. 4.0 ± 1.4 pg/mL, p < 0.01). The hs-TnT level with a cutoff value of 5.5 pg/mL at 6 months had 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months. In our evaluation of echocardiographic parameters at baseline, the diastolic function was more impaired in group R than in group N. The hs-TnT and echocardiographic parameters of diastolic function could be useful to predict trastuzumab-induced cardiotoxicity.

No MeSH data available.


Related in: MedlinePlus

The changes of left ventricular ejection fraction (ΔLVEF) at 3 months (3 m), 6 months (6 m), 9 months (9 m), 12 months (12 m) and 15 months (15 m) versus baseline. Bars represent mean ± SD. #p < 0.05, ##p < 0.01 and ###p < 0.001 comparing group N vs. group R at the same time point. *p < 0.05, **p < 0.01 and ***p < 0.001 within each group vs. baseline with a repeated ANOVA followed by Tukey’s test.
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Fig2: The changes of left ventricular ejection fraction (ΔLVEF) at 3 months (3 m), 6 months (6 m), 9 months (9 m), 12 months (12 m) and 15 months (15 m) versus baseline. Bars represent mean ± SD. #p < 0.05, ##p < 0.01 and ###p < 0.001 comparing group N vs. group R at the same time point. *p < 0.05, **p < 0.01 and ***p < 0.001 within each group vs. baseline with a repeated ANOVA followed by Tukey’s test.

Mentions: The baseline characteristics are listed in Table 1. The body mass index values were significantly higher in group R than in group N (25 ± 3 vs. 22 ± 2, p < 0.05). There was no significant difference between the two groups in age, cardiovascular risk factors, side of breast cancer, radiation use, dose of anthracyclines, or renal function. In the evaluation of echocardiographic parameters at baseline, there was no significant difference in LVEF or LVDd between the two groups. The E/A and e’ values were significantly lower in group R than in group N (1.00 ± 0.36 vs. 1.44 ± 0.41, p < 0.05 and 7.6 ± 2.0 cm/s vs. 11.2 ± 3.2 cm/s, p < 0.05, respectively), and DcT was significantly longer in group R than in group N (227 ± 48 ms vs. 185 ± 26 ms, p < 0.05), showing that diastolic function was more impaired in group R than in group N.The changes of LVEF at 3, 6, 9, 12 and 15 months versus baseline are shown in Figure 2. At 9, 12 and 15 months, the LVEF was significantly reduced in group R compared to group N. In group R, the LVEF was significantly reduced at 6, 9, 12, and 15 months compared to baseline, whereas in group N, the LVEF was not changed at any time point. The reduction of LVEF at 15 months in group R was 9%.Table 1


High-sensitivity troponin T as a marker to predict cardiotoxicity in breast cancer patients with adjuvant trastuzumab therapy.

Katsurada K, Ichida M, Sakuragi M, Takehara M, Hozumi Y, Kario K - Springerplus (2014)

The changes of left ventricular ejection fraction (ΔLVEF) at 3 months (3 m), 6 months (6 m), 9 months (9 m), 12 months (12 m) and 15 months (15 m) versus baseline. Bars represent mean ± SD. #p < 0.05, ##p < 0.01 and ###p < 0.001 comparing group N vs. group R at the same time point. *p < 0.05, **p < 0.01 and ***p < 0.001 within each group vs. baseline with a repeated ANOVA followed by Tukey’s test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4216824&req=5

Fig2: The changes of left ventricular ejection fraction (ΔLVEF) at 3 months (3 m), 6 months (6 m), 9 months (9 m), 12 months (12 m) and 15 months (15 m) versus baseline. Bars represent mean ± SD. #p < 0.05, ##p < 0.01 and ###p < 0.001 comparing group N vs. group R at the same time point. *p < 0.05, **p < 0.01 and ***p < 0.001 within each group vs. baseline with a repeated ANOVA followed by Tukey’s test.
Mentions: The baseline characteristics are listed in Table 1. The body mass index values were significantly higher in group R than in group N (25 ± 3 vs. 22 ± 2, p < 0.05). There was no significant difference between the two groups in age, cardiovascular risk factors, side of breast cancer, radiation use, dose of anthracyclines, or renal function. In the evaluation of echocardiographic parameters at baseline, there was no significant difference in LVEF or LVDd between the two groups. The E/A and e’ values were significantly lower in group R than in group N (1.00 ± 0.36 vs. 1.44 ± 0.41, p < 0.05 and 7.6 ± 2.0 cm/s vs. 11.2 ± 3.2 cm/s, p < 0.05, respectively), and DcT was significantly longer in group R than in group N (227 ± 48 ms vs. 185 ± 26 ms, p < 0.05), showing that diastolic function was more impaired in group R than in group N.The changes of LVEF at 3, 6, 9, 12 and 15 months versus baseline are shown in Figure 2. At 9, 12 and 15 months, the LVEF was significantly reduced in group R compared to group N. In group R, the LVEF was significantly reduced at 6, 9, 12, and 15 months compared to baseline, whereas in group N, the LVEF was not changed at any time point. The reduction of LVEF at 15 months in group R was 9%.Table 1

Bottom Line: We divided the patients into two groups: group R was the nine patients who showed a reduction of left ventricular ejection fraction (LVEF) ≥5%, and group N was the 10 patients who showed a reduction of LVEF <5%.The high-sensitivity troponin T (hs-TnT) level at 6 months was significantly higher in group R than in group N (11.0 ± 7.8 pg/mL vs. 4.0 ± 1.4 pg/mL, p < 0.01).The hs-TnT level with a cutoff value of 5.5 pg/mL at 6 months had 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan.

ABSTRACT
The humanized monoclonal antibody trastuzumab has been in routine use for chemotherapy for human epidermal growth factor receptor II (HER2)-positive breast cancer. A major adverse effect of trastuzumab is cardiotoxicity. Well-established biomarkers or echocardiographic parameters to predict trastuzumab-induced cardiotoxicity have not yet been determined. We attempted to identify useful biomarkers and/or echocardiographic parameters to predict trastuzumab-induced cardiotoxicity. We prospectively investigated the cases of 19 women who received chemotherapy including anthracyclines and trastuzumab for HER2-positive breast cancer. We measured cardiac biomarkers and echocardiographic parameters before their chemotherapy and every 3 months up to 15 months until the end of the adjuvant trastuzumab therapy. We divided the patients into two groups: group R was the nine patients who showed a reduction of left ventricular ejection fraction (LVEF) ≥5%, and group N was the 10 patients who showed a reduction of LVEF <5%. The high-sensitivity troponin T (hs-TnT) level at 6 months was significantly higher in group R than in group N (11.0 ± 7.8 pg/mL vs. 4.0 ± 1.4 pg/mL, p < 0.01). The hs-TnT level with a cutoff value of 5.5 pg/mL at 6 months had 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months. In our evaluation of echocardiographic parameters at baseline, the diastolic function was more impaired in group R than in group N. The hs-TnT and echocardiographic parameters of diastolic function could be useful to predict trastuzumab-induced cardiotoxicity.

No MeSH data available.


Related in: MedlinePlus