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Decline in left ventricular ejection fraction following anthracyclines predicts trastuzumab cardiotoxicity

JACC: Heart Failure Sep 02, 2019

Goel S, Liu J, Guo H, et al. - A prospective evaluation of clinical, biochemical, and genomic predictors of trastuzumab-related cardiotoxicity (TRC) was done in the Cardiotoxicity of Adjuvant Trastuzumab Study. From 17 centers, researchers prospectively recruited patients (n = 222) with early-stage human epidermal growth factor receptor 2–positive breast cancer scheduled to receive adjuvant anthracyclines, followed by 12 months of trastuzumab. At baseline, after anthracycline, and every 3 months during trastuzumab, they obtained measurements for left ventricular ejection fraction (LVEF), troponin T, and N-terminal prohormone of brain natriuretic peptide. The factors that independently predicted TRC in this study were low baseline LVEF and greater LVEF decline after anthracycline. No further improvement in the ability to predict TRC was seen with the other biomarkers.

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