State of the art paper Prognostic role of troponin and natriuretic peptides as biomarkers for deterioration of left ventricular ejection fraction after chemotherapy

Abstract

Cardiotoxicity due to anthracyclines, trastuzumab and other potential cardiotoxic drugs is still a problem of modern chemotherapy. For years researchers have tried to find biological markers that can predict changes in the heart. The most thoroughly tested markers are troponin and natriuretic peptides. Some studies have proven that these markers can indeed be useful. In studies which have shown the predictive role of troponin I the assessment of this marker was performed very frequently. It is not possible to carry out such serial measurements in many centers because of typical 1-day hospital stay times. The predictive role of natriuretic peptides still needs further investigation. This review considers the newest research from recent years.

Successful recovery and allogeneic stem cell transplant following chemotherapy-induced severe cardiomyopathy: literature review of management and prognostic factors

“…Patients at high risk of AIC can be identified at an early stage with an efficient N-terminal prohormone brain natriuretic peptide (NT-proBNP),12 which is deemed to be relatively better than the commonly employed cardiac troponin I 13 14. Other AIC biomarkers, including growth differentiating factors-15 (GDF-15), CBR1, AKR1A1 and AKR7A2 protein, and topoisomerase2β (Top2β) were studied in different populations and can also be used 15 16.…”

Alternative Biomarkers for Combined Biology

“…With current clinical guidelines somewhat conservative in defining CRCD (i.e., reduction of LVEF > 10% or development of clinical heart failure) 2 , investigators had difficulty in demonstrating the predictability of potential biomarkers. 57, 58 Inconsistent timing of blood sampling among cohort studies or groups in a cohort might have also played a role in contradictory results in the biomarker studies. In particular, many chemotherapy protocols have changed to a one-day hospital stay where frequent blood sampling for serial assessment of the biomarkers becomes implausible.…”

“…In particular, many chemotherapy protocols have changed to a one-day hospital stay where frequent blood sampling for serial assessment of the biomarkers becomes implausible. 57 …”

Liposomal doxorubicin in patients with breast cancer and concomitant cardiovascular diseases — interdisciplinary expert opinion

“…5. Jeśli ośrodek dysponuje możliwością pomiaru troponiny lub peptydów natriuretycznych (peptyd natriuretyczny typu B [BNP] lub N-końcowy propeptyd natriuretyczny typu B [NT-proBNP]), to oznaczanie obydwu markerów (zwłaszcza troponiny) może być pomocne w identyfikowaniu chorych z toksycznym uszkodzeniem serca w trakcie chemioterapii doksorubicyną liposomalną [34]. Wymieniona sytuacja wymaga bezwzględnie przeprowadzenia wspólnej konsultacji kardiologa i onkologa z oceną dalszych korzyści oraz ryzyka kontynuowania leczenia przeciwnowotworowego.…”