Role of Clinical Risk Factors and B-Type Natriuretic Peptide in Assessing the Risk of Asymptomatic Cardiotoxicity in Breast Cancer Patients in Kazakhstan †
Tlegenova Z. Balmagambetova S. Zholdin B. Kurmanalina G. Talipova I. Koyshybaev A. Sultanbekova G. Baspayeva M. Madinova S. Kubenova K. Amanova A. Tamadon A.
December 2023Multidisciplinary Digital Publishing Institute (MDPI)
Diagnostics
2023#13Issue 23
The asymptomatic progression of chemotherapy-induced cardiotoxicity poses a significant risk to breast cancer patients. In the present single-center cohort study, a predictive model for evaluating the risk of cardiotoxicity during or by the end of chemotherapy was designed. The risk-prediction nomogram was delineated and assessed. In total, 34 patients out of 120 developed asymptomatic cardiotoxicity (28.3%). Of six explored biomarkers, only B-type natriuretic peptide showed a reliable pattern of incremental increase, revealing statistical significance between cardiotoxicity “+” and “−” groups by visit 4 or by the 9th month of monitoring (p 0.006). The following predictors were included in the model: age, hypertension, diabetes mellitus, baseline glomerular filtration rate, 6 min walk test measured at visit 4, BNP values at visit 4, left ventricular ejection fraction levels at visit 4, a total dose of radiotherapy received, and anthracycline cumulative doses. The model’s AUC was 0.72 (95% CI 0.59; 0.86), evidencing the satisfactory predictive ability of the model; sensitivity 100% (95% CI 90.36; 100.0) at a specificity of 66.67% (95% CI 50.33; 79.79); PPV 54.1% [95% CI 47.13; 60.91]; PVN 100% [95% CI 94.64; 100.00]. The calibration plot showed satisfactory agreement between predicted and actual chances (p = 0.98). The designed model can be applied in settings lacking speckle tracking echocardiography.
B-type natriuretic peptide , biomarkers , breast cancer , cardiotoxicity , chemotherapy , Kazakhstan , predictive models , risk factors
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Department of Internal Diseases-2, West Kazakhstan Marat Ospanov Medical University, Aktobe, 030019, Kazakhstan
Department of Oncology, West Kazakhstan Marat Ospanov Medical University, Aktobe, 030019, Kazakhstan
Chemotherapy Division at University Medical Center, West Kazakhstan Marat Ospanov Medical University, Aktobe, 030019, Kazakhstan
Clinical Laboratory at University Medical Center, West Kazakhstan Marat Ospanov Medical University, Aktobe, 030017, Kazakhstan
Percia Vista R&D Co., Shiraz, Iran
Department for Scientific Work, Ospanov Medical University, West Kazakhstan Marat, Aktobe, 030019, Kazakhstan
Department of Internal Diseases-2
Department of Oncology
Chemotherapy Division at University Medical Center
Clinical Laboratory at University Medical Center
Percia Vista R&D Co.
Department for Scientific Work
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