High-Sensitivity Troponin T and NT-proBNP Kinetics in Breast Cancer Chemotherapy

Pooja Advani, Jonathan Hoyne, Alvaro Moreno-Aspita, Marcia Dubin, Shelly Brock, Caroline Harlow, Saranya Chumsri, Thomas Suter, Joseph L. Blackshear

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background/Aims: Doxorubicin (DOX) and trastuzumab (TRA) are associated with cardiac dysfunction. Method: High-sensitivity troponin T (hs-TnT) and brain natriuretic peptide attached to the amino acid N-terminal fragment in the prohormone (NT-proBNP) were measured before and on days +1, +2, +3, and +7 during cycles 1 and 2 of therapy with DOX or TRA in breast cancer patients. Results: Five of eleven DOX-treated women, compared with 2/11 TRA-treated women, had undetectable baseline hs-TnT. By day +1 of cycle 2, all the DOX-treated women (p = 0.03) but only 7/11 TRA-treated women (p = ns) had detectible hs-TnT. Time to peak was 1-2 days for both groups. In the DOX-treated women, hs-TnT showed significant peaks from precycle baseline, increases in precycle 1 to precycle 2 levels, and a cycle 1 to cycle 2 peak and area under the curve (AUC). hs-TnT increased from precycle (1, 4.6 ± 6.3 pg/mL) to a cycle 2 peak of 16.1 ± 15.0 pg/mL (p < 0.002). No increases were seen with the TRA treatment. Transient posttreatment increases in NT-proBNP were seen after both therapies. Conclusion: DOX was associated with increased pretreatment baseline, peak, and AUC hs-TnT levels. Both DOX and TRA acutely perturb NT-proBNP. Assessment of pre- and posttreatment hs-TnT could be a means of quantifying cumulative myocardial injury in the course of chemotherapy.

Original languageEnglish (US)
Pages (from-to)334-338
Number of pages5
Issue number6
StatePublished - Nov 1 2017


  • Brain natriuretic peptide
  • Breast cancer
  • Doxorubicin
  • Echocardiography
  • High-sensitivity troponin T
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Drug Discovery
  • Pharmacology (medical)
  • Infectious Diseases


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