AIMS: Cardiac biomarkers are a mainstay in diagnosis of cardiovascular disease but their role in cardio-oncology has not yet been systematically evaluated. This meta-analysis aims to determine whether cardiac troponins and (N-terminal pro) brain natriuretic peptide (BNP/NT-proBNP) predict cancer therapy-related left ventricular (LV) dysfunction. METHODS AND RESULTS: Scientific databases were searched for studies that assessed troponins or BNP/NT-proBNP in adult patients undergoing cancer therapy. Data from 61 trials with 5691 patients were included. Cancer therapy was associated with an increase in troponin levels [odds ratio (OR) 14.3, 95% confidence interval (CI) 6.0-34.1; n = 3049]. Patients with elevated troponins receiving chemotherapy or human epidermal growth factor receptor 2 inhibitor therapy were at higher risk for LV dysfunction (OR 11.9, 95% CI 4.4-32.1; n = 2163). Troponin had a negative predictive value of 93%. Mean BNP/NT-proBNP levels were increased in patients post-treatment (standardized mean difference 0.6, 95% CI 0.3-0.9; n = 912), but the available evidence did not consistently indicate prediction of LV dysfunction (OR 1.7, 95% CI 0.7-4.2; n = 197). β-blocker and angiotensin-converting enzyme inhibitor therapy to mitigate cardiotoxicity during cancer therapy was associated with a decline in serum troponins (OR 4.1, 95% CI 1.7-9.8; n = 466). CONCLUSION: Elevated troponin levels predict LV dysfunction in patients receiving cancer therapy. Assessment of troponin levels may qualify as a screening test to identify patients who require referral to cardio-oncology units and benefit from preventive strategies. Further evidence is required for both biomarkers.
AIMS: Cardiac biomarkers are a mainstay in diagnosis of cardiovascular disease but their role in cardio-oncology has not yet been systematically evaluated. This meta-analysis aims to determine whether cardiac troponins and (N-terminal pro) brain natriuretic peptide (BNP/NT-proBNP) predict cancer therapy-related left ventricular (LV) dysfunction. METHODS AND RESULTS: Scientific databases were searched for studies that assessed troponins or BNP/NT-proBNP in adult patients undergoing cancer therapy. Data from 61 trials with 5691 patients were included. Cancer therapy was associated with an increase in troponin levels [odds ratio (OR) 14.3, 95% confidence interval (CI) 6.0-34.1; n = 3049]. Patients with elevated troponins receiving chemotherapy or humanepidermal growth factor receptor 2 inhibitor therapy were at higher risk for LV dysfunction (OR 11.9, 95% CI 4.4-32.1; n = 2163). Troponin had a negative predictive value of 93%. Mean BNP/NT-proBNP levels were increased in patients post-treatment (standardized mean difference 0.6, 95% CI 0.3-0.9; n = 912), but the available evidence did not consistently indicate prediction of LV dysfunction (OR 1.7, 95% CI 0.7-4.2; n = 197). β-blocker and angiotensin-converting enzyme inhibitor therapy to mitigate cardiotoxicity during cancer therapy was associated with a decline in serum troponins (OR 4.1, 95% CI 1.7-9.8; n = 466). CONCLUSION: Elevated troponin levels predict LV dysfunction in patients receiving cancer therapy. Assessment of troponin levels may qualify as a screening test to identify patients who require referral to cardio-oncology units and benefit from preventive strategies. Further evidence is required for both biomarkers.
Authors: Daniel Finke; Markus B Heckmann; Susanna Wilhelm; Lukas Entenmann; Hauke Hund; Nina Bougatf; Hugo A Katus; Norbert Frey; Lorenz H Lehmann Journal: Clin Res Cardiol Date: 2022-03-21 Impact factor: 5.460
Authors: Jakub Lagan; Josephine H Naish; Christien Fortune; Christopher Campbell; Shien Chow; Manon Pillai; Joshua Bradley; Lenin Francis; David Clark; Anita Macnab; Gaetano Nucifora; Rebecca Dobson; Erik B Schelbert; Matthias Schmitt; Robert Hawkins; Christopher A Miller Journal: Diagnostics (Basel) Date: 2022-05-30
Authors: José Luis Zamorano; Christer Gottfridsson; Riccardo Asteggiano; Dan Atar; Lina Badimon; Jeroen J Bax; Daniela Cardinale; Antonella Cardone; Elizabeth A M Feijen; Péter Ferdinandy; Teresa López-Fernández; Chris P Gale; John H Maduro; Javid Moslehi; Torbjørn Omland; Juan Carlos Plana Gomez; Jessica Scott; Thomas M Suter; Giorgio Minotti Journal: Eur J Heart Fail Date: 2020-10-02 Impact factor: 15.534
Authors: Ting Xu; Qing H Meng; Susan C Gilchrist; Steven H Lin; Ruitao Lin; Tianlin Xu; Sarah A Milgrom; Saumil J Gandhi; Haijun Wu; Yu Zhao; Juan C Lopez-Mattei; Radhe Mohan; Zhongxing Liao Journal: Int J Radiat Oncol Biol Phys Date: 2021-07-21 Impact factor: 8.013