N-terminal pro-brain natriuretic peptide levels after receipt of anthracycline for breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24103-e24103
Author(s):  
Shruti R Patel ◽  
Joerg Herrmann ◽  
Robert A. Vierkant ◽  
Janet E. Olson ◽  
Fergus Couch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Risk ◽  
The United States ◽  
Linear Regression Models ◽  
Cardiac Risk Factors ◽  
Anthracycline Therapy ◽  
Er Status

e24103 Background: Many of the 200,000 patients diagnosed with breast cancer (BC) annually in the United States receive anthracycline-based therapy, increasing their risk of future congestive heart failure. N-terminal brain natriuretic peptide (NT-proBNP) has been used as a biomarker of asymptomatic cardiac dysfunction in the general population and is of interest to identify patients who might benefit from echocardiography during survivorship. This study aimed to assess how age, baseline comorbidities, and time since BC diagnosis impact NT-proBNP levels after anthracycline-based chemotherapy. Methods: This retrospective study, using samples collected in our ongoing prospective Mayo Clinic Breast Disease Registry, included 20 survivors of non-metastatic BC patients per year for each of the first 5 years after anthracycline-based chemotherapy (n=100 total). NT-pro-BNP levels were assessed using a Roche immunoassay. Cardiac risk factors were obtained by chart review. Multivariable linear regression models assessed associations between NT-proBNP values and these independent variables: baseline cardiac risk factors (including hypertension, hyperlipidemia, obesity, diabetes mellitus, and smoking), tumor ER status (surrogate for possible endocrine therapy), time between diagnosis and serum collection, T and N status, use of trastuzumab, and age. Results: The mean age at the time of BC diagnosis was 52.2 (SD 9.8). 13% of tumors were human epidermal growth factor receptor (HER2)-positive and 71% were estrogen receptor (ER) positive. NT-proBNP was elevated in 34%. Mean NT-BNP level was higher (p=0.047) for those in years 4-5 (158 pg/mL) compared to those in years 1-3 (106 pg/mL) (See Table.) Models revealed years from diagnosis to serum draw (p=0.026), older age (p=0.006), more cardiac risk factors (p=0.064), and N2-3 (p=0.001) were associated with elevated NT-pro-BNP level. Use of trastuzumab, ER status, and tumor size were not associated with NT-proBNP. Conclusions: NT-proBNP is elevated in 1/3 of survivors who received anthracycline therapy for BC. As expected, cardiac risk factors and advancing age are associated with higher NT-proBNP. NT-proBNP values >300 were only found in patients who were 4-5 years after diagnosis. Additional research will be needed to further define the diagnostic and prognostic merit of NT-proBNP in survivors after receipt of anthracycline therapy. [Table: see text]

Conventional cardiac risk factors associated with trastuzumab-induced cardiotoxicity in breast cancer: Systematic review and meta-analysis

2021 ◽  
pp. 100723
Author(s):  
George Koulaouzidis ◽  
Amanda E. Yung ◽  
Diana E. Yung ◽  
Karolina Skonieczna-Żydecka ◽  
Wojciech Marlicz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Cardiac Risk ◽  
Factors Associated ◽  
Cardiac Risk Factors

Cardioprotection with ICRF-187 (Cardioxane) in patients with advanced breast cancer having cardiac risk factors for doxorubicin cardiotoxicity, treated with the FDC regimen

1995 ◽  
Vol 3 (3) ◽  
pp. 176-182 ◽  
Author(s):  
Svetislav Jelić ◽  
Siniša Radulović ◽  
Zora Nešković-Konstantinović ◽  
Miroslav Kreačić ◽  
Zorana Ristović ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Advanced Breast Cancer ◽  
Cardiac Risk ◽  
Advanced Breast ◽  
Cardiac Risk Factors ◽  
Doxorubicin Cardiotoxicity

Adjuvant chemotherapy with or without an anthracycline in older adults with node-negative triple-negative breast cancer (TNBC): A SEER Medicare study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12505-e12505
Author(s):  
Anna R Schreiber ◽  
Jodi Kagihara ◽  
Megan Eguchi ◽  
Peter Kabos ◽  
Elisabeth Meyer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Older Patients ◽  
Clinical Decision Making ◽  
Breast Cancer Subtype ◽  
Cardiac Risk ◽  
Node Negative ◽  
Cardiac Risk Factors

e12505 Background: TNBC is an aggressive breast cancer subtype comprising approximately 15% of breast cancers. Adjuvant chemotherapy reduces the risk of recurrence, particularly in patients with tumors > 1 cm or node positive disease. Anthracycline (A) + taxane (T)-containing regimens are more efficacious than T-based regimens, however, the risk of cardiac toxicity is greater in older patients. We investigated the use of AT and T-containing regimens in patients ≥ 66 years old with node negative TNBC and evaluated clinical outcomes and cardiac risk factors. Methods: We identified female patients ≥ 66 diagnosed between 2010-2015 with TNBC node negative disease in the Surveillance, Epidemiology, and End Results (SEER) Medicare database. Baseline characteristics, including age, tumor size, cardiac history, and adjuvant chemotherapy administration (AT vs. T) were collected. A logistic regression analysis was performed to estimate independent predictors of AT vs. T chemotherapy. Overall survival (OS) was estimated at 3 years. Results: We identified 3348 patients, including 1679 (50.2%) who received chemotherapy for T1a/bN0 (32.5%), T1cN0 (55.5%), T2N0 (57.0%) and T3/T4N0 (49.6%) disease. Of those, 984 (58.6%) received T, 420 (25.0%) received AT and 275 (16.4%) received other chemotherapy. AT use was associated with larger tumor size; T1a/bN0 (13.6%), T1cN0 (21.3%), T2N0 (31.6%) and T3/T4N0 (34.9%). In a multivariate analysis, independent predictors of AT vs. T were age, region treated in the USA, tumor size and presence of prior cardiac risk factors or pre-existing cardiac disease. OS at 3 years was 91% for T and 86% for AT (p 0.03). Conclusions: Approximately half of older patients diagnosed with node negative TNBC received adjuvant chemotherapy. T-based regimens were more commonly used than AT regimens. Younger age, higher stage and lack of cardiac comorbidities correlated with use of AT compared to T. Continued investigation of the benefit of adjuvant chemotherapy in older patients may assist in clinical decision making.

scholarly journals 86 Conventional cardiac risk factors associated with trastuzumab-induced cardiotoxicity in breast cancer: a meta-analysis

2019 ◽  
Author(s):  
Ramesh Nadarajah ◽  
Georgios Koulaouzidis ◽  
Dafni Charisopoulou ◽  
Diana Yung ◽  
Amanda Yung
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Meta Analysis ◽  
Cardiac Risk ◽  
Factors Associated ◽  
Cardiac Risk Factors

scholarly journals A prospective study on the need of gated (GAT) radiotherapy in left sided breast cancer patients treated at the Technical University Munich (TUM) The GATTUM Trial: Study Protocol (Preprint)

2018 ◽  
Author(s):  
Marciana Nona Duma ◽  
Markus Oechsner ◽  
Christina Ertl ◽  
Petra Mozes ◽  
Silvia Reitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Dose Reduction ◽  
Cancer Patients ◽  
Cardiac Risk ◽  
Deep Inspiration ◽  
Breast Cancer Patients ◽  
Cardiac Risk Factors ◽  
Heart Dose ◽  
Radiation Planning

BACKGROUND Deep inspiration breathhold (DIBH) it is the most widely used technique for heart sparing. Nonetheless, treatment preparation, patient coaching and treatment planning/ delivery can be more time consuming than conventional techniques. OBJECTIVE The aim of our study is to find predictive measurements that will allow an estimation of the heart dose reduction by DIBH and thus allow a precise selection of these patients. METHODS The GATTUM trial is a single institution, prospective pilot study. 150 breast cancer patients who will undergo radiotherapy at the university hospital ‘Klinikum rechts der Isar’ will be included in the study. All patients will undergo breathing triggered radiation planning with a CT during free breathing (FB) and a CT during deep inspiration breath hold (DIBH). Patients without cardiac risk factors with heart Dmean ≥ 3 Gy and for patients with cardiac risk factors with heart Dmean ≥ 2Gy are recommended to undergo radiation therapy in DIBH. The primary endpoint of the study is to identify measurements that will predict the heart dose reduction in DIBH. Secondary endpoints include quality of life and cosmesis. RESULTS The measurements that we aim to find by this study are to be performed on a planning CT or a diagnostic CT performed beforehand; easy to perform by each staff member; correlated with clinical data (such as breast size; heart and lung morphometry; heart and lung comorbidities) and correlated with the a 3D CRT tangential field “standard” dose distribution. CONCLUSIONS This study could help to improve the knowledge about the necessity of respiratory-gated radiotherapy. We expect that evidence-based indications regarding optimization-criteria for radiation planning of breast cancer patients can be determined for the first time. CLINICALTRIAL The study was retrospectively registered on the 23rd of May 2018 on clinicaltrials.gov with the following ID: NCT03534570. https://clinicaltrials.gov/ct2/show/NCT03534570 The study is currently recruiting patients. The first patient was recruited on 15th October 2015.

Regional Cervical Plexus Blockage for Carotid Endarterectomy in Patients with Cardiovascular Risk Factors

2015 ◽  
Vol 18 (4) ◽  
pp. 140 ◽  
Author(s):  
Mehmet Taşar ◽  
Mehmet Kalender ◽  
Okay Güven Karaca ◽  
Ata Niyazi Ecevit ◽  
Salih Salihi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Endarterectomy ◽  
Regional Anesthesia ◽  
Carotid Artery Disease ◽  
Risk Groups ◽  
Cardiac Risk ◽  
Cervical Plexus ◽  
Cardiac Risk Factors ◽  
Significant Difference

Background: Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors. <br />Methods: We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy ± patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared.<br />Results: Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P &gt; .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection.<br />Conclusion: Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed. <br /><br />

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