title: Echocardiography and cardiac biomarkers in patients with non-small cell lung cancer treated with platinum-based chemotherapy.
abstract: BACKGROUND
  Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and remains an important cause of cancer death worldwide. Platinum-based chemotherapy (PBC) for NSCLC can modify outcome while the risk of cardiotoxicity remains poorly researched. We aimed to evaluate the incidence and severity of cardiac injury during PBC in patients with NSCLC and to identify patients at risk.
  
  
  METHODS
  This was a single-centre, prospective, observational study of patients with early and advanced stage NSCLC referred for PBC. In addition to standard care, patients were examined and evaluated for cardiotoxicity before the first dose (visit 1), at the last dose (visit 2) and 6 months after the last dose of PBC (visit 3). Cardiotoxicity (at visit 2 and 3) was defined as increase in the ultrasensitive troponin T, N-terminal pro-B type natriuretic peptide or decrease in left ventricular ejection fraction (LVEF).
  
  
  RESULTS
  Overall, 41 patients (mean age 61 ± 9; 54% men; 68% advanced lung cancer) were included. The median number of PBC cycles was 4. During the study period, there were no incidents of heart failure, and 3 deaths caused by tumour progression were recorded. The mean values of biomarkers and LVEF did not change significantly (p > 0.20). However, 10 (25%) had cardiotoxicity which was independently associated with a history of ischemic heart disease (p = 0.026).
  
  
  CONCLUSIONS
  In NSCLC, cardiac assessment and lifestyle modifications may be pursued in patients with a history of cardiac disease and in patients with longer life expectancy.
authors.affiliation: National Institute of Public Health, Ljubljana, Slovenia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Omersa
authors.affiliation: University Clinic Golnik, Golnik, Slovenia; Faculty of Medicine, Ljubljana, Slovenia.
authors.forename: Tanja
authors.initials: T
authors.lastname: Cufer
authors.affiliation: University Clinic Golnik, Golnik, Slovenia.
authors.forename: Robert
authors.initials: R
authors.lastname: Marcun
authors.affiliation: Faculty of Medicine, Ljubljana, Slovenia; Departments of Cardiology and Research and Education, General Hospital Celje, Celje, Slovenia.
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
keywords: cardiac biomarkers; cardiotoxicity; lung cancer; platinum-based chemotherapy