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. 2011 Nov 22;105(11):1663-8.
doi: 10.1038/bjc.2011.439. Epub 2011 Nov 8.

Serial measurements of NT-proBNP are predictive of not-high-dose anthracycline cardiotoxicity in breast cancer patients

S Romano  1 , S Fratini, E Ricevuto, V Procaccini, G Stifano, M Mancini, M Di Mauro, C Ficorella, M Penco
Affiliations

Serial measurements of NT-proBNP are predictive of not-high-dose anthracycline cardiotoxicity in breast cancer patients

S Romano et al. Br J Cancer. .

Abstract

Background: The aim of this study was to assess the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting late cardiotoxicity in patients treated with not-high-dose chemotherapy (NHDC), and to compare the predictive value of NT-proBNP and cardiac troponin I (cTnI).

Methods: In 71 patients undergoing NHDC with anthracyclines, NT-proBNP and cTnI levels were measured before and 24 h after each NHDC cycle. Left ventricular (LV) function was assessed by echocardiography at baseline, every two NHDC cycles, at the end of chemotherapy, and at 3-, 6- and 12-month follow-up.

Results: During NHDC, only NT-proBNP showed abnormal values. According to NT-proBNP behaviour, patients were divided into two groups: group A (n=50) with normal (n=23) or transiently elevated NT-proBNP levels (n=27), and group B (n=21) with persistently elevated NT-proBNP levels. At follow-up, LV impairment was significantly worse in group B than in group A. %Δ (baseline-peak) NT-proBNP was predictive of LV impairment at 3-, 6- and 12-month follow-up, with a cutoff of 36%.

Conclusion: Serial measurements of NT-proBNP may be a useful tool for the early detection of patients treated with NHDC at high risk of developing cardiotoxicity.

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Figures

Figure 1
Figure 1
Flowchart of the study protocol: T0=1 week before the beginning of the study; T1=first NHDC cycle; T2=second NHDC cycle; T3=third NHDC cycle; T4=fourth NHDC cycle; T5=fifth NHDC cycle; T6=sixth NHDC cycle.
Figure 2
Figure 2
Serial changes in LVEF (A), LVEDV (B) and LVESV (C) in group A (dashed line) and group B (solid line). Standard deviation is also plotted. *P-value (vs baseline) <0.05; †P-value (A vs B) <0.05.
Figure 3
Figure 3
ROC curves: Δ (baseline–peak) NT-proBNP was predictive of LV impairment at 3- (solid line), 6- (dot-dashed line) and 12-month follow-up (dashed line).
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