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N‐terminal pro‐BNP is a possible early biomarker for the cardiac side‐effects of anthracyclines
Author(s) -
Burggraaf K.,
Arnold F.,
Nickolson V.,
Osanto S.,
Cohen A.
Publication year - 2004
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2003.11.224
Subject(s) - medicine , natriuretic peptide , biomarker , brain natriuretic peptide , cardiomyopathy , statistical significance , cardiology , gastroenterology , heart failure , chemistry , biochemistry
Anthracyclines (ACs) cause cardiac side‐effects which may result in cardiomyopathy. Identification of early biomarkers for this condition is thus useful. The N‐terminal split product of proBrain Natriuretic Peptide (Nt‐pBNP) may be such a biomarker and was included in an exploratory study to identify biomarkers for the cardiac side‐effects of ACs. Three groups were studied: patients who completed a full course of AC‐based chemotherapy (group I), patients starting AC‐based therapy (group II) and a group of gender, age and BMI‐matched controls (group III). Blood samples were taken and ECG recordings made. For group I, measurements were done from ≈1 month after the completion of therapy and 3 times thereafter and compared with the controls from whom samples were collected once. In group II samples were drawn pre‐dose, at cessation, and after 24 hrs for each course. Nt‐pBNP was measured in duplicate using a competitive EIA. Statistical analysis included paired and non‐paired t‐test to detect differences between the time points and groups. Mean (SD) Nt‐pBNP in the patients who completed AC‐therapy was 754 (177) pmol/L which was higher (p<0.01) than in the controls 588 (80) pmol/L. There was a tendency for Nt‐pro‐BNP to slightly decline over time in group I but this was not significant (p=0.21). In group II Ntpro‐BNP increased during the 1 st AC course from 530 (54) pmol/L pre‐dose to 612 (52) pmol/L (p<0.05) immediately post‐dose and further to 789 (124) pmol/L at 24 hours (p=0.001). The pre‐dose value before the 3 rd AC course was 721 (115) pmol/L and thereby higher than the pre‐dose value before the 1 st AC course (p=0.01), and increased to a maximum 1019 (227) pmol/L (p<0.05). Nt‐pBNP seems a promising biomarker for the cardiac effects of ACs and will be explored further. Clinical Pharmacology & Therapeutics (2004) 75 , P59–P59; doi: 10.1016/j.clpt.2003.11.224