title: Serial measurements of NT-proBNP are predictive of not-high-dose anthracycline cardiotoxicity in breast cancer patients.
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%.
  
  
  CONCLUSIONS
  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.
authors: Cardiology, Department of Internal Medicine and Public Health, University of L'Aquila, Piazzale S. Tommasi 1, Coppito, L'Aquila, Italy. silvio.romano@cc.univaq.it
authors: S
authors: S
authors: Romano
authors: S
authors: S
authors: Fratini
authors: E
authors: E
authors: Ricevuto
authors: V
authors: V
authors: Procaccini
authors: G
authors: G
authors: Stifano
authors: M
authors: M
authors: Mancini
authors: M
authors: M
authors: Di Mauro
authors: C
authors: C
authors: Ficorella
authors: M
authors: M
authors: Penco
mesh_terms: D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000139:chemically induced*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004452:Echocardiography / Q000379:methods; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D019210:Troponin I / Q000097:blood; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D018943:Anthracyclines; D014408:Biomarkers, Tumor; D010446:Peptide Fragments; D043823:Taxoids; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000077143:Docetaxel; D015251:Epirubicin; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil