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肌钙蛋白作为化疗所致心脏毒性生物标志物的价值

The Value of Troponin as a Biomarker of Chemotherapy-Induced Cardiotoxicity.

作者信息

Sorodoc Victorita, Sirbu Oana, Lionte Catalina, Haliga Raluca Ecaterina, Stoica Alexandra, Ceasovschih Alexandr, Petris Ovidiu Rusalim, Constantin Mihai, Costache Irina Iuliana, Petris Antoniu Octavian, Morariu Paula Cristina, Sorodoc Laurentiu

机构信息

Department of Internal Medicine, Clinical Emergency Hospital Sfântul Spiridon, 700111 Iasi, Romania.

Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 16 Universitatii Street, 700115 Iasi, Romania.

出版信息

Life (Basel). 2022 Aug 3;12(8):1183. doi: 10.3390/life12081183.

Abstract

In cancer survivors, cardiac dysfunction is the main cause of mortality. Cardiotoxicity represents a decline in cardiac function associated with cancer therapy, and the risk factors include smoking, dyslipidemia, an age of over 60 years, obesity, and a history of coronary artery disease, diabetes, atrial fibrillation, or heart failure. Troponin is a biomarker that is widely used in the detection of acute coronary syndromes. It has a high specificity, although it is not exclusively associated with myocardial ischemia. The aim of this paper is to summarize published studies and to establish the role of troponin assays in the diagnosis of cardiotoxicity associated with various chemotherapeutic agents. Troponin has been shown to be a significant biomarker in the diagnosis of the cardiac dysfunction associated with several types of chemotherapeutic drugs: anthracyclines, anti-human epidermal growth factor receptor 2 treatment, and anti-vascular endothelial growth factor therapy. Based on the data available at this moment, troponin is useful for baseline risk assessment, the diagnosis of cardiotoxicity, and as a guide for the initiation of cardioprotective treatment. There are currently clear regulations regarding the timing of troponin surveillance depending on the patient's risk of cardiotoxicity and the type of medication administered, but data on the cut-off values of this biomarker are still under investigation.

摘要

在癌症幸存者中,心脏功能障碍是主要的死亡原因。心脏毒性表现为与癌症治疗相关的心脏功能下降,其风险因素包括吸烟、血脂异常、60岁以上、肥胖以及冠状动脉疾病、糖尿病、心房颤动或心力衰竭病史。肌钙蛋白是一种广泛用于检测急性冠状动脉综合征的生物标志物。它具有高特异性,尽管它并非仅与心肌缺血相关。本文的目的是总结已发表的研究,并确定肌钙蛋白检测在诊断与各种化疗药物相关的心脏毒性中的作用。肌钙蛋白已被证明是诊断与几种化疗药物相关的心脏功能障碍的重要生物标志物:蒽环类药物、抗人表皮生长因子受体2治疗和抗血管内皮生长因子治疗。根据目前可得的数据,肌钙蛋白可用于基线风险评估、心脏毒性的诊断以及作为启动心脏保护治疗的指导。目前对于根据患者心脏毒性风险和所施用药物类型进行肌钙蛋白监测的时间有明确规定,但关于该生物标志物临界值的数据仍在研究中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26cd/9410123/dca8c1431c6d/life-12-01183-g001.jpg

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