title: Prediction of anthracycline induced cardiotoxicity: study of thirty-one Iraqi adult patients.
abstract: OBJECTIVE
  To look for a nearly ideal tool for prediction of anthracycline-induced cardiotoxicity.
  
  
  METHODS
  Thirty-one patients with various hematological malignancies were included in the study which was conducted from Sept. 2005 to Sept. 2006 in Baghdad Teaching Hospital - Hematology Unit. Initial cardiovascular assessment including cardiac troponin I, electrocardiography and echocardiography were done and repeated one month after the commencement of anthracycline-based regimen. Cardiotoxicity was considered present if the patient has clinical and electrocardiographic evidences, troponin positivity, echocardiographic evidence, or any combination of these.
  
  
  RESULTS
  The mean age for the study sample was 34.1 ± 17.2 years comprising of 17 male and 14 female patients. Increasing age, body surface area, anthracycline dose as well as the concomitant use of cyclophosphomide/All Trans Retinoic Acid were associated with increased risk of cardiotoxicity. The cut-off point of body surface area above which the risk of anthracycline-induced cardiotoxicity is increased was 1.88 m2 while the cut-off point for anthracyclines dose was 145.5 mg/m2. The constellation of clinical data, ECG, and cTnI was 92% predictive of early evidence of anthracycline-induced cardiotoxicity. More weight is added when echocardiography is used as a diagnostic tool. The incidence of cardiotoxicity attributed to treatment was 38.7%. The predictive power of cardiac troponin I alone was 58.3%, whereas it increases to 91% when combined with electrocardiography and to 95% when combined with echocardiographic study.
  
  
  CONCLUSIONS
  The age, anthracyclines dose and the use of other chemotherapeutics increase the risk of anthracycline-induced cardiotoxicity. Cardiac troponin I is a simple non-invasive indicator for the presence of anthracycline-induced cardiotoxicity especially when used in combination with other parameters.
authors: Baghdad Teaching Hospital, The Medical City, Iraq. ala1975@gmail.com
authors: A A S
authors: AA
authors: Ali
authors: A M J
authors: AM
authors: Al-Mudhafar
mesh_terms: D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D019210:Troponin I / Q000032:analysis
chemical_list: D018943:Anthracyclines; D019210:Troponin I