MULTIPLE BIOMARKERS IN THE EVALUATION OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY | XVII. výroční sjezd České kardiologické společnosti

Aim: Evaluation of acute and chronic cardiotoxicity of anthracyclines with multiple biomarkers of cardiac injury: myoglobin, creatine kinase MB (CK-MB mass), cardiac troponin T (cTnT), cardiac troponin I (cTnI), heart-type fatty acid binding protein (H-FABP) and glycogen phosphorylase BB (GPBB). H-FABP and GPBB have not been studied in this setting so far.
Patients and Methods: A total of 24 acute leukemia patients (mean age 48.1±10.9 years, 13 males) treated with 3–6 cycles of anthracycline-based chemotherapy were studied. All biomarkers were measured at the baseline, after first chemotherapy (CT) with anthracyclines, after last CT with anthracyclines (mean total cumulative dose 463.2±114.3 mg/m2) and 6 months thereafter. Values above the reference range were considered elevated.
Results: GPBB increased above the cut-off (7.30 µg/L) in 4 (16.7 %) patients after first CT, in 5 (20.8 %) patients after last CT and remained elevated in 5 (20.8 %) patients within 6 months after CT. CTnI became elevated (above 0.40 µg/L) in 2 (8.3 %) patients after first and last CT and was elevated in 3 (12.5 %) patients within 6 months after CT. CTnT remained negative (below 0.01 µg/L) during CT in all patients. Six months after CT, delayed cTnT positivity was found in 2 (8.3 %) patients. All patients with cTnI or cTnT positivity had elevated GPBB. Other tested biomarkers (myoglobin, CK-MB mass, H-FABP) remained within the reference range in all patients.
Conclusion: Our results suggest that GPBB could be a new promising biomarker for detection of anthracycline-induced cardiotoxicity and probably superior to cardiac troponins. The predictive value for development of cardiomyopathy in the future is not known and will be evaluated during a prospective follow-up. Further studies will be needed.
Supported by research projects MO 0FVZ 0000503 and MZO 00179906.

MULTIPLE BIOMARKERS IN THE EVALUATION OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY Tématický okruh: Varia
Typ: Ústní sdělení - lékařské , Číslo v programu: 578


Horáček J.¹, Tichý M.², Jebavý L.¹, Ulrychová M.³, Pudil R.⁴ ¹ Katedra válečného vnitřního lékařství, Fakulta vojenského zdravotnictví, Hradec Králové, ² Ústav klinické biochemie a diagnostiky, Fakultní nemocnice, Hradec Králové, ³ ÚKBD, Fakultní nemocnice, Hradec Králové, ⁴ I. interní kardioangiologická klinika, Fakultní nemocnice, Hradec Králové
Aim: Evaluation of acute and chronic cardiotoxicity of anthracyclines with multiple biomarkers of cardiac injury: myoglobin, creatine kinase MB (CK-MB mass), cardiac troponin T (cTnT), cardiac troponin I (cTnI), heart-type fatty acid binding protein (H-FABP) and glycogen phosphorylase BB (GPBB). H-FABP and GPBB have not been studied in this setting so far. Patients and Methods: A total of 24 acute leukemia patients (mean age 48.1±10.9 years, 13 males) treated with 3–6 cycles of anthracycline-based chemotherapy were studied. All biomarkers were measured at the baseline, after first chemotherapy (CT) with anthracyclines, after last CT with anthracyclines (mean total cumulative dose 463.2±114.3 mg/m2) and 6 months thereafter. Values above the reference range were considered elevated. Results: GPBB increased above the cut-off (7.30 µg/L) in 4 (16.7 %) patients after first CT, in 5 (20.8 %) patients after last CT and remained elevated in 5 (20.8 %) patients within 6 months after CT. CTnI became elevated (above 0.40 µg/L) in 2 (8.3 %) patients after first and last CT and was elevated in 3 (12.5 %) patients within 6 months after CT. CTnT remained negative (below 0.01 µg/L) during CT in all patients. Six months after CT, delayed cTnT positivity was found in 2 (8.3 %) patients. All patients with cTnI or cTnT positivity had elevated GPBB. Other tested biomarkers (myoglobin, CK-MB mass, H-FABP) remained within the reference range in all patients. Conclusion: Our results suggest that GPBB could be a new promising biomarker for detection of anthracycline-induced cardiotoxicity and probably superior to cardiac troponins. The predictive value for development of cardiomyopathy in the future is not known and will be evaluated during a prospective follow-up. Further studies will be needed. Supported by research projects MO 0FVZ 0000503 and MZO 00179906.

PROHLÍŽENÍ ABSTRAKTA