Abstract edit: HEartCORE
In preparation for the German German Cardiac Society conference (#DGK2022), I have been selecting abstracts for the sessions that I would like to attend. I have been editing them live on LinkedIn (see video below), but I really messed this one up during the video and I wanted to take some time to correct this in depth and showcase this amazing research!
As a medical doctor myself, I understand the importance of ensuring that research, and particularly incredible research like this, reaches as many people in the English-speaking community as possible. If you find that my changes have made the text easier to read, please contact me to find more about my services and what I can offer you!
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|Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5|
|Cardiac biomarker associate with all-cause mortality in cancer patients – data from the HEidelberg Cardio-Oncology REgistry (HEartCORE)|
|S. Romann et al.|
|Aims: Cardio-oncology is a burgeoning interdisciplinary field that aims to reduce cancer patient morbidity and mortality by optimising cardiological management. We previously documented the utility of high-sensitivity Troponin T (hs-TnT) when stratifying cancer patients with a poor prognosis. We aimed to further validate these findings, so we gathered five years’ worth of data at Heidelberg Cardio-Oncology outpatient clinics. |
Methods: We collected data from 1971 cancer patients in the HEidelberg Cardio-Oncology REgistry (HEartCORE) from January 2016 to December 2020. Patients were admitted to the cardio-oncology unit at the Heidelberg University Hospital based on the relevant and current American Heart Association (AHA) and European Society of Cardiology (ESC) guidelines. We examined the medical history, physical condition, 12-lead-ECG and 2D echocardiography findings, including global longitudinal strain (GLS) if technical feasible, in all patients. Cardiac biomarkers (high-sensitivity cardiac troponin T [hs-cTnT] and N-terminal brain natriuretic peptide [NT-proBNP]) were also measured during this process. Patient data was usually obtained before the initiation of a new chemotherapy regimen (1167, 59.2%).
Results: Most patients were suffering from breast cancer (n = 852, 43.2%), upper gastrointestinal carcinoma (n = 206, 10.5%) or multiple myeloma (n = 118, 6.0%). The left ventricular ejection fraction was preserved (LVEF >50%) in 85.6% of patients upon initial examination, and remained high at first follow up after three months (82.7%, median 97.00 days [IQR 61.00, 147.00]) and second follow up after six months (80.9%, median of an additional 90.00 days [IQR 57.00, 120.00]). This larger cohort allowed us to confirm our previous findings, i.e. hs-cTnT of ≥7 ng/L (multivariant logistic regression, OR: 1.77, p = 0.00034) and elevated NT-proBNP (multivariant logistic regression, OR: 1,76, p = 0.00006) were independent predictors of all-cause mortality (ACM) among all registry patients. However, we found no significant association between increased ACM and reduced LVEF (multivariant analysis; p=0.13) in the overall analysis. Meanwhile, NT-proBNP was highly significantly associated with increased ACM in non-breast cancer patients (multivariant logistic regression, OR: 1.86, p = 0.00086). We then focused on the breast cancer patient subgroup (n=852) and found a highly significant association between increased ACM and reduced LVEF (multivariant logistic regression, OR: 2.81, p = <0.00025). hs-cTnT was also a strong predictor of ACM in this subgroup. The presence of dyslipidemia was associated with increased hs-cTnT (logistic regression, OR: 2.36; p = <0.00001), while a history of smoking was not associated with increased cardiac biomarkers or ACM (p=0.25).
Conclusions: In our current cardio-oncology cohort, hs-cTnT levels correlated with increased mortality above a cut-off value of 7 ng/L. NT-proBNP also appears to be a useful additional biomarker for stratifying cancer patient risk. Moreover, we noted found that the sensitivity of available cardiac stratification tools differed significantly by tumour entity. We conclude that cardiac biomarker measurement is an important tool for stratifying cancer patient mortality risk and additional studies must be conducted to determine tumour-specific biomarkers for effective cardiac follow up.
|The original version has not been included here due to copyright|