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

Kenji Nakatsuma; Neiko Ozasa; Mikiko Ohno; Hiroshi Ishiguro; Manabu Minami; Eiichiro Nishi; Masakazu Toi; Koh Ono; Takeshi Kimura

doi:10.1016/j.jjcc.2024.03.005

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

J Cardiol. 2024 Mar 22:S0914-5087(24)00044-3. doi: 10.1016/j.jjcc.2024.03.005. Online ahead of print.

Authors

Kenji Nakatsuma¹, Neiko Ozasa², Mikiko Ohno³, Hiroshi Ishiguro⁴, Manabu Minami⁵, Eiichiro Nishi³, Masakazu Toi⁶, Koh Ono⁷, Takeshi Kimura⁸

Affiliations

¹ Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.
² Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: nei126@kuhp.kyoto-u.ac.jp.
³ Department of Pharmacology, Shiga University of Medical Science, Shiga, Japan.
⁴ Department of Breast Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
⁵ Department of Data Science, National Cerebral and Cardiovascular Center, Osaka, Japan.
⁶ Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁷ Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁸ Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan.

PMID: 38521118
DOI: 10.1016/j.jjcc.2024.03.005

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.