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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 hs-TnT level at 6 months predicts a reduction of LVEF at 15 months.(A) The correlation between the changes of high-sensitivity troponin T (∆hs-TnT) at 6 months and the changes of left ventricular ejection fraction (∆LVEF) at 15 months. (B) The dot diagram depicting the distribution of hs-TnT at 6 months in each group. (C) The ROC curve analysis of hs-TnT at 6 months in both groups. The transverse dot line in (B) and the arrow in (C) indicate the cutoff point of hs-TnT that provides the maximum value by adding sensitivity to specificity.
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Fig3: The hs-TnT level at 6 months predicts a reduction of LVEF at 15 months.(A) The correlation between the changes of high-sensitivity troponin T (∆hs-TnT) at 6 months and the changes of left ventricular ejection fraction (∆LVEF) at 15 months. (B) The dot diagram depicting the distribution of hs-TnT at 6 months in each group. (C) The ROC curve analysis of hs-TnT at 6 months in both groups. The transverse dot line in (B) and the arrow in (C) indicate the cutoff point of hs-TnT that provides the maximum value by adding sensitivity to specificity.

Mentions: Figure 3A shows the changes of hs-TnT levels at 6 months significantly correlated with the changes of LVEF at 15 months (r = -0.56, p < 0.05). The distribution of hs-TnT levels at 6 months and the ROC curve analysis of hs-TnT levels at 6 months are shown in Figure 3B and Figure 3C, respectively. At 6 months, seven of the nine patients in group R were above the hs-TnT cutoff value of 5.5 pg/mL, providing 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months.Figure 3


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 hs-TnT level at 6 months predicts a reduction of LVEF at 15 months.(A) The correlation between the changes of high-sensitivity troponin T (∆hs-TnT) at 6 months and the changes of left ventricular ejection fraction (∆LVEF) at 15 months. (B) The dot diagram depicting the distribution of hs-TnT at 6 months in each group. (C) The ROC curve analysis of hs-TnT at 6 months in both groups. The transverse dot line in (B) and the arrow in (C) indicate the cutoff point of hs-TnT that provides the maximum value by adding sensitivity to specificity.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: The hs-TnT level at 6 months predicts a reduction of LVEF at 15 months.(A) The correlation between the changes of high-sensitivity troponin T (∆hs-TnT) at 6 months and the changes of left ventricular ejection fraction (∆LVEF) at 15 months. (B) The dot diagram depicting the distribution of hs-TnT at 6 months in each group. (C) The ROC curve analysis of hs-TnT at 6 months in both groups. The transverse dot line in (B) and the arrow in (C) indicate the cutoff point of hs-TnT that provides the maximum value by adding sensitivity to specificity.
Mentions: Figure 3A shows the changes of hs-TnT levels at 6 months significantly correlated with the changes of LVEF at 15 months (r = -0.56, p < 0.05). The distribution of hs-TnT levels at 6 months and the ROC curve analysis of hs-TnT levels at 6 months are shown in Figure 3B and Figure 3C, respectively. At 6 months, seven of the nine patients in group R were above the hs-TnT cutoff value of 5.5 pg/mL, providing 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months.Figure 3

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