Evaluation of anthracycline-induced cardiotoxicity using cardiac biomarkers: A prospective study

Though anthracyclines are the commonly used chemotherapeutics for cancer treatment, close monitoring of patients is required due to its well reported cardiotoxicity. The present study evaluates the role of biomarkers [N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin-T (hs-cTnT)] in early prediction of cardiotoxicity in patients with breast and ovarian cancer who received anthracyclines.

This was a single-center observational study conducted between August-2018 and January-2020. Doxorubicin was used as an anthracycline at a dose of 50 mg/m2 per cycle. All the patients underwent echocardiography before the start and at 3 months, 6 months and 12 months after chemotherapy. NT-proBNP and hs-cTnT levels were measured before as baseline and within 24 hours of the first and last cycle of anthracycline-based chemotherapy.

A total of 72 patients with breast and ovarian cancer participated in the study. The mean age of patients was 49.4 ± 10.3 years. Sixty six (91.7%) patients had breast cancer and 9 (12.5%) patients developed cardiotoxicity. Mean age of the patients who developed cardiotoxicity was 55.00 ± 12.5 years. The level of NT-proBNP and hs-cTnT were significantly increased after the last cycle of anthracycline in patients who developed cardiotoxicity.

The measurement of NT-proBNP and hs-cTnT levels after anthracycline administration helps detect early sub-clinical cardiotoxicity and thus can assist in modification of therapeutic regimens and initiation of heart failure therapy to prevent future cardiac events.