Progressive Elevation of NT-ProBNP During Chemotherapy Is Related to Asymptomatic Cardiovascular Events in Patients With Multiple Myeloma
| Autor: | Li Bao, Lei Shi, Shan Gao, Minqiu Lu, Qiuqing Xiang, Lina Fu, Yutong Wang, Lijuan Fang, Bin Chu |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.drug_class medicine.medical_treatment Pilot Projects 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Natriuretic Peptide Brain Natriuretic peptide Medicine Humans Multiple myeloma Subclinical infection Aged Aged 80 and over Chemotherapy Ejection fraction Troponin T business.industry Hematology Middle Aged medicine.disease Peptide Fragments Cross-Sectional Studies Oncology Cardiovascular Diseases 030220 oncology & carcinogenesis Heart failure Cardiology Female medicine.symptom business Multiple Myeloma |
| Zdroj: | Clinical lymphoma, myelomaleukemia. 19(3) |
| ISSN: | 2152-2669 |
| Popis: | Patients with multiple myeloma (MM) are at risk of cardiovascular events (CVEs) as a result of disease burden- and treatment-related risk factors. Cardiac biomarkers have been reported to be more sensitive than left ventricular ejection fraction in detecting CVEs. We sought to explore CVEs risk factors in MM patients and to establish sensitive predictors of biomarkers.We studied 116 newly diagnosed MM patients who received chemotherapy in our department. Echocardiograms were examined at baseline and after 4 cycles of treatment, as well as upon clinical suspicion of a cardiac event or after an adjustment of treatment regimens. Cardiac biomarkers, including troponin T, myohemoglobin, and N terminal pro B-type natriuretic peptide (NT-proBNP), were estimated before each cycle and within 24 hours after chemotherapy, which was provided for at least 4 cycles.Thirteen patients (11.2%) experienced CVEs, seven of which were subclinical. There was no significant difference between the CVE group and the non-CVE group in terms of general patient characteristics, MM disease factors, or chemotherapy drugs. The baseline levels of left ventricular ejection fraction and NT-proBNP were comparable between the 2 groups. NT-proBNP levels increased rapidly after chemotherapy and fell to normal levels before administration of the next cycle in all patients (60 pg/mL vs. 446 pg/mL, P.001). Patients with asymptomatic CVEs showed a significantly higher proportion of progressively elevated NT-proBNP compared to symptomatic CVE and non-CVE patients (57% vs. 0 vs. 6.1%, P = .035).The dynamic change in NT-proBNP may predict early asymptomatic cardiac damage and allow interventional strategies to avoid cardiac decompensation. |
| Databáze: | OpenAIRE |
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