High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study
Abstract Aims Cardio‐oncology is a growing interdisciplinary field which aims to improve cardiological care for cancer patients in order to reduce morbidity and mortality. The impact of cardiac biomarkers, echocardiographic parameters, and cardiological assessment regarding risk stratification is st...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-10-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13515 |
| _version_ | 1818717056243073024 |
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| author | Daniel Finke Sebastian W. Romann Markus B. Heckmann Hauke Hund Nina Bougatf Ajith Kantharajah Hugo A. Katus Oliver J. Müller Norbert Frey Evangelos Giannitsis Lorenz H. Lehmann |
| author_facet | Daniel Finke Sebastian W. Romann Markus B. Heckmann Hauke Hund Nina Bougatf Ajith Kantharajah Hugo A. Katus Oliver J. Müller Norbert Frey Evangelos Giannitsis Lorenz H. Lehmann |
| author_sort | Daniel Finke |
| collection | DOAJ |
| description | Abstract Aims Cardio‐oncology is a growing interdisciplinary field which aims to improve cardiological care for cancer patients in order to reduce morbidity and mortality. The impact of cardiac biomarkers, echocardiographic parameters, and cardiological assessment regarding risk stratification is still unclear. We aimed to identify potential parameters that allow an early risk stratification of cancer patients. Methods and results In this cohort study, we evaluated 930 patients that were admitted to the cardio‐oncology outpatient clinic of the University Hospital Heidelberg from January 2016 to January 2019. We performed echocardiography, including Global Longitudinal Strain (GLS) analysis and measured cardiac biomarkers including N‐terminal pro brain‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity cardiac troponin T levels (hs‐cTnT). Most patients were suffering from breast cancer (n = 450, 48.4%), upper gastrointestinal carcinoma (n = 99, 10.6%) or multiple myeloma (n = 51, 5.5%). At the initial visit, we observed 86.7% of patients having a preserved left ventricular ejection fraction (LVEF >50%). At the second follow up, still 78.9% of patients showed a preserved LVEF. Echocardiographic parameters or elevation of NT‐proBNP did not significantly correlate with all‐cause mortality (ACM) (logistic regression LVEF <50%: P = 0.46, NT‐proBNP: P = 0.16) and failed to identify high‐risk patients. In contrast, hs‐cTnT above the median (≥7 ng/L) was an independent marker to determine ACM (multivariant logistic regression, OR: 2.21, P = 0.0038) among all included patients. In particular, hs‐cTnT levels before start of a chemotherapy were predictive for ACM. Conclusions Based on our non‐selected cohort of cardio‐oncological patients, hs‐cTnT was able to identify patients with high mortality by using a low cutoff of 7 ng/L. We conclude that measurement of hs‐cTnT is an important tool to stratify the risk for mortality of cancer patients before starting chemotherapy. |
| first_indexed | 2024-12-17T19:29:05Z |
| format | Article |
| id | doaj.art-59488184b8434266b12135f109d7cf1d |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-17T19:29:05Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-59488184b8434266b12135f109d7cf1d2022-12-21T21:35:18ZengWileyESC Heart Failure2055-58222021-10-01853709371910.1002/ehf2.13515High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort studyDaniel Finke0Sebastian W. Romann1Markus B. Heckmann2Hauke Hund3Nina Bougatf4Ajith Kantharajah5Hugo A. Katus6Oliver J. Müller7Norbert Frey8Evangelos Giannitsis9Lorenz H. Lehmann10Department of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyClinical Cancer Registry, National Centre for Tumor Diseases (NCT) Heidelberg Heidelberg GermanyDepartment of Cardiology University Hospital Frankfurt am Main Frankfurt am Main GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyDepartment of Cardiology University Hospital Kiel Kiel GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyDepartment of Internal Medicine III: Cardiology, Angiology & Pulmonology Heidelberg University Hospital Heidelberg GermanyAbstract Aims Cardio‐oncology is a growing interdisciplinary field which aims to improve cardiological care for cancer patients in order to reduce morbidity and mortality. The impact of cardiac biomarkers, echocardiographic parameters, and cardiological assessment regarding risk stratification is still unclear. We aimed to identify potential parameters that allow an early risk stratification of cancer patients. Methods and results In this cohort study, we evaluated 930 patients that were admitted to the cardio‐oncology outpatient clinic of the University Hospital Heidelberg from January 2016 to January 2019. We performed echocardiography, including Global Longitudinal Strain (GLS) analysis and measured cardiac biomarkers including N‐terminal pro brain‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity cardiac troponin T levels (hs‐cTnT). Most patients were suffering from breast cancer (n = 450, 48.4%), upper gastrointestinal carcinoma (n = 99, 10.6%) or multiple myeloma (n = 51, 5.5%). At the initial visit, we observed 86.7% of patients having a preserved left ventricular ejection fraction (LVEF >50%). At the second follow up, still 78.9% of patients showed a preserved LVEF. Echocardiographic parameters or elevation of NT‐proBNP did not significantly correlate with all‐cause mortality (ACM) (logistic regression LVEF <50%: P = 0.46, NT‐proBNP: P = 0.16) and failed to identify high‐risk patients. In contrast, hs‐cTnT above the median (≥7 ng/L) was an independent marker to determine ACM (multivariant logistic regression, OR: 2.21, P = 0.0038) among all included patients. In particular, hs‐cTnT levels before start of a chemotherapy were predictive for ACM. Conclusions Based on our non‐selected cohort of cardio‐oncological patients, hs‐cTnT was able to identify patients with high mortality by using a low cutoff of 7 ng/L. We conclude that measurement of hs‐cTnT is an important tool to stratify the risk for mortality of cancer patients before starting chemotherapy.https://doi.org/10.1002/ehf2.13515Cardio‐oncologyCardiac biomarkersHeart failureCardiotoxicityCancer survivorsRisk stratification |
| spellingShingle | Daniel Finke Sebastian W. Romann Markus B. Heckmann Hauke Hund Nina Bougatf Ajith Kantharajah Hugo A. Katus Oliver J. Müller Norbert Frey Evangelos Giannitsis Lorenz H. Lehmann High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study ESC Heart Failure Cardio‐oncology Cardiac biomarkers Heart failure Cardiotoxicity Cancer survivors Risk stratification |
| title | High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study |
| title_full | High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study |
| title_fullStr | High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study |
| title_full_unstemmed | High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study |
| title_short | High‐sensitivity cardiac troponin T determines all‐cause mortality in cancer patients: a single‐centre cohort study |
| title_sort | high sensitivity cardiac troponin t determines all cause mortality in cancer patients a single centre cohort study |
| topic | Cardio‐oncology Cardiac biomarkers Heart failure Cardiotoxicity Cancer survivors Risk stratification |
| url | https://doi.org/10.1002/ehf2.13515 |
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