engleski

NT-proBNP in anthracycline-induced cardiotoxicity in children

Background: Anthracyclines (doxorubicin, daunorubicin and idarubicin) are highly efficacious antineoplastic agents for various malignances in children but their usefulness has been limited by cardiotoxicity causing cardiomyopathy and heart failure. The aim of this study was to assess the diagnostic accuracy of N-terminal-prohormone brain natriuretic peptide (NT-proBNP) in recognizing anthracycline related cardiotoxicity in children. Materials and methods: Serum levels of NT-proBNP were measured by electrochemiluminescence immunoassay (ECLIA) on the Cobas e 411 analyser (Roche Diagnostic, Mannheim, Germany. Results: We included 32 patients with median age of 15 years, who received anthracyclines in their chemotherapy. All patients had undergone cardiac evaluation that included electrocardiography and echocardiography. Toxicity was assessed according to the National Cancer Institute (NCI) Common toxicity criteria (version 2.0. With cut off of 125.0 pg/mL, sensitivity of NT-proBNP was 55.5% and specificity only 40.0%. The area under the receiver operating characteristic (ROC) curve was 0.548 (95% confidence interval (CI): 0.363-0.724) and odds ratio 0.83. Positive predictive value was 83.3 (95% CI: 58.6-96.4) and negative predictive value 14.3 (95%CI: 1.8-42.8). There was no statistical difference between serum NT-proBNP levels of the patients with normal and abnormal echocardiographic and electrocardiographic findings (P = 0.736. Conclusions: Due to specificity and sensitivity of NTproBNP, present study indicated that electrocardiographic and echocardiographic follow-up is more reliable than serum NT-proBNP levels for detecting cardiotoxicity. Further investigations in finding non-invasive and practical method for monitoring to identify cardiac damage at subclinical level are necessary.

NT-proBNP; cardiotoxicity; child; tumors

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