Cardiac Troponin I Predicts Elevated B-type Natriuretic Peptide in Patients Treated with Anthracycline-Containing Chemotherapy
Cardiac Troponin I Predicts Elevated B-type Natriuretic Peptide in Patients Treated with Anthracycline-Containing Chemotherapy
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DOI：
10.1159/000507585
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发表时间：
2020-09-01
期刊：
影响因子：
3.5
通讯作者：
Takeishi, Yasuchika
中科院分区：
文献类型：
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作者：
Oikawa, Masayoshi;Yoshihisa, Akiomi;Takeishi, Yasuchika
背景：蒽环类抗生素被用于治疗各种类型的癌症，然而，心脏毒性会对患者预后产生负面影响。目的：本研究的目的是调查一系列的变化，在与蒽环类抗生素治疗患者的心肌肌钙蛋白I（TnI）和B型利钠肽（BNP）。方法：91例连续癌症患者计划蒽环类抗生素治疗，并随访12个月。结果：根据随访期间的TnI水平，将患者分为两组：TnI升高组（TnI ≥ 0.03 ng/mL;n= 37）和TnI正常组（n= 54）。在TnI升高组中，TnI水平在3和6个月时升高，但在蒽环类药物给药后12个月时恢复到正常范围内。与TnI不同，BNP水平在6个月后开始升高，并在12个月时保持升高。与TnI正常组相比，TnI升高组中癌症治疗相关心功能障碍的发生率更高。当我们将TnI的临界值设定为0.029 ng/mL时，预测BNP水平升高超过100 pg/mL的灵敏度和特异性分别为90%和63%。多因素Logistic回归分析显示，TnI升高是BNP升高的独立预测因子。结论：TnI升高是BNP升高的独立预测因子。在管理含蒽环类药物治疗的患者时，应考虑TnI和BNP的不同特征。
Background:Anthracycline is used to treat various types of cancer; however, cardiotoxicity negatively affects patient prognosis.Objectives:The aim of the present study was to investigate serial changes in levels of cardiac troponin I (TnI) and B-type natriuretic peptide (BNP) in patients treated with anthracycline-containing therapy.Methods:91 consecutive cancer patients planned for anthracycline treatment were enrolled and followed up for 12 months. All patients underwent echocardiography and blood sampling at baseline, 3, 6, and 12 months.Results:The patients were divided into two groups based on their TnI level during the follow-up period: the elevated TnI group (TnI >= 0.03 ng/mL;n= 37) and the normal TnI group (n= 54). In the elevated TnI group, the TnI levels increased at 3 and 6 months, but they returned to within normal range at 12 months after anthracycline administration. Unlike TnI, the BNP levels began to increase after 6 months, and remained increased at 12 months. The occurrence of cancer therapeutics-related cardiac dysfunction was higher in the elevated TnI group than in the normal TnI group. When we set the cut-off value of TnI at 0.029 ng/mL, sensitivity and specificity to predict an elevated BNP level of more than 100 pg/mL were 90 and 63%, respectively. Multivariate logistic regression analysis revealed that elevated TnI was an independent predictor of elevated BNP levels.Conclusion:Elevated TnI was an independent predictor for the development of BNP increase. The different characteristics of TnI and BNP should be considered when managing patients treated with anthracycline-containing therapy.