Early increase of high-sensitivity cardiac troponin predicts mortality in cancer patients undergoing chemotherapy. (14th October 2021)

• Record Type: Journal Article
• Authors: Nowakowska, M A; Chrzanowski, L; Miskowiec, D; Wdowiak-Okrojek, K; Wejner-Mik, P; Lipiec, P; Krakowska, M; Potemski, P; Plonska-Gosciniak, E; Kasprzak, J D
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Cardio-Oncology; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.2867
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Introduction: High-sensitivity cardiac troponin test (hs-TnT) reveals subclinical myocardial damage in many cardiac conditions. We hypothesized that elevated hs-TnT may predict a development of cancer therapy-related cardiac dysfunction and clinical outcomes linked with antineoplastic therapies. We aimed to evaluate the predictive value of hs-TnT for all-cause mortality in a group of patients (pts) with recent diagnosis of cancer. Material and methods: We included 80 pts (mean age 57±13 years; 98% women) with recently diagnosed cancer (78 breast cancer, 1 colon cancer, 1 DLBCL lymphoma). Transthoracic echocardiography and hs-TnT tests were performed at baseline and after 3, 6 and 12-months. Pts with LVEF <50% and significant valvular disease were excluded. Results: In the study group 44% pts had arterial hypertension, 54% dyslipidemia, 9% diabetes mellitus; 94% pts were treated with anthracyclines, 30% with trastuzumab, 54% with hormone therapy, 71% with radiotherapy. A significant decrease of LVEF were observed during follow-up (LVEF at baseline, 3, 6 and 12 months: 61.7±2.0%; 60.9±2.0%*; 60.8±2.9%*; 59.9±2.9%*; *p<0.05 vs baseline). A significant reduction of global longitudinal strain was found only at 6-month follow-up (−19, 2±2, 2% vs −18, 6±2, 0%; p=0, 003). In 38 pts at least a twofold (fourfold in37) increase in hs-TnT >99th percentile was observed. A rise of hs-TnT was most often seen at 3 month (n=35; 43, 8%). During median 1056 (221–1906) days off follow-up 18 (24%) pts died and ROC curve analysis revealed that early (0–3 months) hs-TnT increase more than 10 pg/ml [AUC=0, 693 (0, 545–0, 806); p=0, 017)] represented a predictor of death [OR=3, 4 (1, 99–11, 87)]. Conclusions: Increase in hs-TnT in cancer patients detected at 3rd month of chemotherapy predicts mortality. Funding Acknowledgement: Type of funding sources: None.