Patel Shruti Rajesh, Herrmann Joerg, Vierkant Robert A, Olson Janet E, Couch Fergus J, Hazim Antonious, Sloan Jeff A, Loprinzi Charles L, Ruddy Kathryn J
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55901, USA.
Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN 55901, USA.
J Clin Med. 2021 Jul 27;10(15):3313. doi: 10.3390/jcm10153313.
NT-proBNP, soluble ST2 (sST2), and galectin-3 are biomarkers of cardiac dysfunction that have been proposed as identifiers of patients experiencing asymptomatic cardiac dysfunction after anthracycline-based chemotherapy. This study aimed to compare the proportion of breast cancer (BC) survivors with elevated serum levels of these three putative biomarkers by prior receipt of anthracycline (yes vs. no). Five-hundred-eighty survivors of BC who had received anthracycline-based chemotherapy were matched by age and time between diagnosis and serum storage to 580 who had not. Cardiac biomarker levels were analyzed using immunoassays. Analyses were carried out using linear and logistic regression models. Anthracycline recipients had higher values of NT-proBNP than non-recipients (mean 116.0 ng/L vs. 97.0 ng/L, respectively; < 0.001). Values for ST2 and galectin-3 did not significantly differ by receipt of anthracycline. After further adjustment for age at breast cancer diagnosis, ethnicity, and receipt of trastuzumab, associations between receipt of anthracycline and higher NT-proBNP persisted ( < 0.001), showing that NT-proBNP may be a biomarker of cardiovascular toxicity after receipt of anthracycline-based chemotherapy. Further research to assess the clinical utility of NT-proBNP testing after receipt of anthracycline is recommended. sST2 and galectin-3 do not appear to differentiate between anthracycline recipients and non-recipients amongst breast cancer survivors.
N末端B型利钠肽原（NT-proBNP）、可溶性ST2（sST2）和半乳糖凝集素-3是心脏功能障碍的生物标志物，已被提议作为蒽环类药物化疗后无症状心脏功能障碍患者的识别指标。本研究旨在比较既往接受过蒽环类药物治疗（是与否）的乳腺癌（BC）幸存者中这三种假定生物标志物血清水平升高的比例。580名接受过蒽环类药物化疗的BC幸存者按年龄以及诊断与血清储存之间的时间与580名未接受过蒽环类药物化疗的幸存者进行匹配。使用免疫测定法分析心脏生物标志物水平。采用线性和逻辑回归模型进行分析。接受蒽环类药物治疗者的NT-proBNP值高于未接受者（分别为平均116.0 ng/L和97.0 ng/L；<0.001）。ST2和半乳糖凝集素-3的值在是否接受蒽环类药物治疗方面无显著差异。在进一步调整乳腺癌诊断时的年龄、种族和曲妥珠单抗的使用情况后，蒽环类药物治疗与较高的NT-proBNP之间的关联仍然存在（<0.001），表明NT-proBNP可能是接受蒽环类药物化疗后心血管毒性的生物标志物。建议进一步研究以评估蒽环类药物治疗后NT-proBNP检测的临床实用性。在乳腺癌幸存者中，sST2和半乳糖凝集素-3似乎无法区分接受蒽环类药物治疗者和未接受者。
