• Rev Assoc Med Bras (1992) · Jan 2024

    Observational Study

    Biomarkers and prediction of anthracyclic cardiotoxicity in breast cancer.

    • Eduardo Nani Silva, Mario Luiz Ribeiro, Lilian Campos Caldeira, Antonio José Lagoeiro Jorge, RosaMaria Luiza GarciaMLG0000-0002-4508-256XUniversidade Federal Fluminense, Postgraduate Program in Cardiovascular Sciences - Niterói (RJ), Brazil., Evandro Tinoco Mesquita, Humberto Villacorta, and Wolney de Andrade Martins.
    • Universidade Federal Fluminense, Postgraduate Program in Cardiovascular Sciences - Niterói (RJ), Brazil.
    • Rev Assoc Med Bras (1992). 2024 Jan 1; 70 (suppl 1): e2024S106e2024S106.

    BackgroundChemotherapy with doxorubicin may lead to left ventricular dysfunction. There is a controversial recommendation that biomarkers can predict ventricular dysfunction, which is one of the most feared manifestations of anthracycline cardiotoxicity.ObjectiveThe aim of this study was to evaluate the behavior of biomarkers such as Troponin I, type B natriuretic peptide, creatine phosphokinase fraction MB, and myoglobin in predicting cardiotoxicity in a cohort of women with breast cancer undergoing chemotherapy with anthracycline.MethodsThis is an observational, prospective, longitudinal, unicentric study, which included 40 women with breast cancer, whose therapeutic proposal included treatment with doxorubicin. The protocol had a clinical follow-up of 12 months. Biomarkers such as Troponin I, type B natriuretic peptide, creatine phosphokinase fraction MB, and myoglobin were measured pre-chemotherapy and after the first, third, fourth, and sixth cycles of chemotherapy.ResultsThere was a progressive increase in type B natriuretic peptide and myoglobin values in all chemotherapy cycles. Although creatine phosphokinase fraction MB showed a sustained increase, this increase was not statistically significant. Troponin, type B natriuretic peptide, myoglobin, and creatine phosphokinase fraction MB were the cardiotoxicity markers with the earliest changes, with a significant increase after the first chemotherapy session. However, they were not able to predict cardiotoxicity.ConclusionTroponin I, type B natriuretic peptide, myoglobin, and creatine phosphokinase fraction MB are elevated during chemotherapy with doxorubicin, but they were not able to predict cardiotoxicity according to established clinical and echocardiographic criteria. The incidence of subclinical cardiotoxicity resulting from the administration of doxorubicin was 12.5%.

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