Abstract 14091: Subclinical Cardiac Dysfunction in the Patients Treated With Anthracycline-Containing Chemotherapy in the Chronic Phase

Abstract

Background: Anthracycline-induced cardiotoxicity is a concerning problem in the treatment of a variety of cancers. The highest incidence of anthracycline-induced cardiotoxicity was observed during the first year after the completion of chemotherapy, but the changes in cardiac function and biomarkers after the first year have not been adequately investigated. Methods: We analyzed 105 consecutive patients who were followed up for 24 months after starting anthracycline-containing chemotherapy in our hospital from June 2018 to April 2021. Echocardiography and blood test for troponin I and B-type natriuretic peptide (BNP) were performed at baseline, 3 months, 6 months, 12 months, and 24 months after starting the chemotherapy. Results: The cancer types included 71 breast cancers, 18 hematologic cancers, 11 gynecologic cancers, and 5 soft tissue tumors. Compared to baseline, troponin I levels were increased at 3 months (0.011±0.007 ng/ml vs. 0.021±0.021 ng/ml, P<0.05) and 6 months (0.023±0.047 ng/ml, P<0.001), then, recovered to baseline levels. In contrast, BNP levels remained unchanged for 12 months but increased at 24 months compared to baseline (31.9 [5.8-625.7] pg/ml vs. 15.5 [5.8-89.2] pg/ml, P<0.01). In addition, the left ventricular ejection fraction was decreased from baseline to 6 months (65.4±4.8% vs. 63.6±4.5%, P<0.05) and 24 months (63.6±4.7%, P<0.05). Multivariate logistic analysis revealed that age (OR 1.049, 95% CI [1.006-1.097], P=0.029) and total anthracycline dose (OR 1.011, 95% CI [1.002-1.022], P=0.026) were predicting factors for elevated BNP levels above the normal range (>18.2 pg/ml) at 24 months. Conclusion: Subclinical cardiac dysfunction was developed after more than one year. Long-term follow-up is desirable to detect cardiac dysfunction in patients treated with anthracycline-containing chemotherapy.