title: The Utility of Point-of-Care Biomarkers to Detect Cardiotoxicity During Anthracycline Chemotherapy: A Feasibility Study.
abstract: BACKGROUND
  Anthracycline chemotherapy is associated with an increased risk of developing heart failure (HF). The current standard for detecting HF or cardiotoxicity during chemotherapy involves episodic cardiac imaging typically at prescribed intervals and there are limited studies examining techniques beyond measuring left ventricular (LV) function. This study explores whether cardiac biomarkers troponin I (TnI) and B-type natriuretic peptide (BNP) could be part of a screening strategy for early detection of the development of cardiotoxicity in patients undergoing anthracycline chemotherapy.
  
  
  RESULTS
  Patients were enrolled from a single medical center. Cardiac biomarkers (TnI, BNP) were measured before and within 24 hours after completion of anthracycline administration for each cycle of therapy. Cardiac imaging was obtained at baseline and at completion of chemotherapy (commonly at 6 or 12 months) or based on clinical suspicion of a cardiac event. Of the enrolled 109 patients, 11 (10.1%) experienced cardiac events; all of these patients had at least 1 BNP value >100 pg/mL before the cardiac event. Significant reduction in LV ejection fraction as defined for cardiotoxicity occurred in only 3 of 10 patients (30%) with a cardiac event.
  
  
  CONCLUSIONS
  The use of cardiac biomarkers, particularly BNP, may allow early detection of cardiotoxicity related to anthracycline chemotherapy.
authors.affiliation: Division of Cardiovascular Medicine, Vanderbilt University, Nashville, Tennessee. Electronic address: daniel.lenihan@vanderbilt.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lenihan
authors.affiliation: Division of Cardiovascular Medicine, Vanderbilt University, Nashville, Tennessee.
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Stevens
authors.affiliation: Department of Cardiology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Mona
authors.initials: M
authors.lastname: Massey
authors.affiliation: Division of Cardiology, Baylor College of Medicine, Houston, Texas.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Plana
authors.affiliation: Sarcoma Department, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Dejka M
authors.initials: DM
authors.lastname: Araujo
authors.affiliation: Lymphoma Department, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fanale
authors.affiliation: Lymphoma Department, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Fayad
authors.affiliation: Division of General Oncology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
authors.affiliation: Department of Cardiology, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Edward T H
authors.initials: ET
authors.lastname: Yeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D066126:Cardiotoxicity / Q000097:blood / Q000175:diagnosis; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*; D019095:Point-of-Care Systems; D019210:Troponin I / Q000097:blood*; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D015415:Biomarkers; D019210:Troponin I; D020097:Natriuretic Peptide, Brain
keywords: Anthracycline cardiotoxicity; biomarkers; cardioprotection