Subclinical myocardial damage after anthracycline chemotherapy in Japanese patients with breast cancer

J Cardiol. 2024 Oct;84(4):260-265. doi: 10.1016/j.jjcc.2024.03.005. Epub 2024 Mar 22.

Abstract

Background: Data on the incidence, timing, and severity of myocardial damage after anthracycline-based chemotherapy (AC) in Japanese patients with breast cancer are limited.

Method: We evaluated cancer therapy-related cardiac dysfunction (CTRCD) in Japanese women with breast cancer (n = 51) after the first AC according to the definitions of the 2022 European Society of Cardiology onco-cardiology guideline, including assessment of high-sensitivity troponin I (TnI) and B-type natriuretic peptide (BNP) levels.

Results: CTRCD was detected in 67 % of the patients (3.9 %, 7.8 %, 9.8 %, 43 %, 37 %, 22 %, 20 %, and 9.8 % of patients at 1 week and 1, 2, 3, 6, 9, 12, and 15 months post-AC, respectively) without significant left ventricular ejection fraction reduction (<50 %) and heart failure. Elevated TnI levels (>26 pg/mL) were found in 43 % of patients, and elevated BNP levels (≥35 pg/mL) were observed in 22 % of patients during the follow-up period.

Conclusions: Approximately two-thirds of the Japanese patients in this study experienced CTRCD, which was frequently observed at 3 or 6 months post-AC. However, all patients with CTRCD were diagnosed with mild asymptomatic CTRCD. Although, these patients were diagnosed with mild asymptomatic CTRCD, careful long-term follow-up will be required.

Keywords: Anthracycline; Biomarkers; Breast cancer.

MeSH terms

  • Adult
  • Aged
  • Anthracyclines* / administration & dosage
  • Anthracyclines* / adverse effects
  • Breast Neoplasms* / drug therapy
  • Cardiotoxicity / etiology
  • East Asian People
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Middle Aged
  • Natriuretic Peptide, Brain* / blood
  • Stroke Volume
  • Troponin I* / blood

Substances

  • Anthracyclines
  • Natriuretic Peptide, Brain
  • Troponin I