Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin

Cardiac biomarkers are a vital component within the first edition of the European Society of Cardiology guidelines in Cardio-Oncology. Specifically, they are mentioned in the definition of mild asymptomatic cancer therapy-related cardiac dysfunction, where left ventricular systolic function is ≥50 %...

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Main Authors: Michael Cronin, Dina Neiroukh, Aoife Lowery, William Wijns, Michael Kerin, Maccon Keane, Silvie Blazkova, Osama Soliman
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:International Journal of Cardiology: Heart & Vasculature
Online Access:http://www.sciencedirect.com/science/article/pii/S235290672400188X
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author Michael Cronin
Dina Neiroukh
Aoife Lowery
William Wijns
Michael Kerin
Maccon Keane
Silvie Blazkova
Osama Soliman
author_facet Michael Cronin
Dina Neiroukh
Aoife Lowery
William Wijns
Michael Kerin
Maccon Keane
Silvie Blazkova
Osama Soliman
author_sort Michael Cronin
collection DOAJ
description Cardiac biomarkers are a vital component within the first edition of the European Society of Cardiology guidelines in Cardio-Oncology. Specifically, they are mentioned in the definition of mild asymptomatic cancer therapy-related cardiac dysfunction, where left ventricular systolic function is ≥50 % with two outcomes; either a new decrease in global longitudinal strain >15 % from baseline and/or a new rise in cardiac biomarkers above the defined 99th percentile cut off values. Cardiac troponin is one such biomarker.Many of the treatments for breast cancer have published data on cardiac dysfunction and/or cardiovascular toxicity, and such may lead to an elevation in cardiac troponin. However, there is conflicting and incomplete data regarding how to approach an elevated cardiac troponin during anti-cancer treatment, which has confounded patient care in the clinical trial setting.We propose a novel framework to guide physicians in treatment-related elevation of cardiac troponin in the breast cancer population. Secondly, the additive role which the recommendation that cardiac troponin carries within mild asymptomatic definitions of CTRCD is the subject of great debate. We suggest a reflection on the role of biomarkers, specifically in reference to cardiac troponin.
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issn 2352-9067
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publisher Elsevier
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series International Journal of Cardiology: Heart & Vasculature
spelling doaj-art-9633fa8917c64d20958f8d30b8398d722025-08-20T02:06:57ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672024-12-015510152210.1016/j.ijcha.2024.101522Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponinMichael Cronin0Dina Neiroukh1Aoife Lowery2William Wijns3Michael Kerin4Maccon Keane5Silvie Blazkova6Osama Soliman7University of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of IrelandUniversity of Galway, School of Medicine, Galway, Republic of Ireland; Netherlands: Euro Heart Foundation, Netherlands; Corresponding author at: School of Medicine, University of Galway, H91 V4AY Galway, Ireland.Cardiac biomarkers are a vital component within the first edition of the European Society of Cardiology guidelines in Cardio-Oncology. Specifically, they are mentioned in the definition of mild asymptomatic cancer therapy-related cardiac dysfunction, where left ventricular systolic function is ≥50 % with two outcomes; either a new decrease in global longitudinal strain >15 % from baseline and/or a new rise in cardiac biomarkers above the defined 99th percentile cut off values. Cardiac troponin is one such biomarker.Many of the treatments for breast cancer have published data on cardiac dysfunction and/or cardiovascular toxicity, and such may lead to an elevation in cardiac troponin. However, there is conflicting and incomplete data regarding how to approach an elevated cardiac troponin during anti-cancer treatment, which has confounded patient care in the clinical trial setting.We propose a novel framework to guide physicians in treatment-related elevation of cardiac troponin in the breast cancer population. Secondly, the additive role which the recommendation that cardiac troponin carries within mild asymptomatic definitions of CTRCD is the subject of great debate. We suggest a reflection on the role of biomarkers, specifically in reference to cardiac troponin.http://www.sciencedirect.com/science/article/pii/S235290672400188X
spellingShingle Michael Cronin
Dina Neiroukh
Aoife Lowery
William Wijns
Michael Kerin
Maccon Keane
Silvie Blazkova
Osama Soliman
Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
International Journal of Cardiology: Heart & Vasculature
title Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
title_full Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
title_fullStr Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
title_full_unstemmed Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
title_short Proposed framework regarding management of patients with breast cancer and anti-cancer treatment-related elevation in cardiac troponin
title_sort proposed framework regarding management of patients with breast cancer and anti cancer treatment related elevation in cardiac troponin
url http://www.sciencedirect.com/science/article/pii/S235290672400188X
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