RISK SCORE MODEL FOR PREDICTING CARDIOTOXICITY IN BREAST CANCER: DIAGNOSTIC VALUE OF HIGH-SENSITIVITY CARDIAC TROPONIN T.

N V Dovganych, S M Kozhukhov, I I Smolanka, O F Lygyrda, O Ye Bazyka, S A Lyalkin, O A Yarynkina
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Abstract

Cardiovascular diseases are the second leading cause of death among breast cancer (BC) patients. Prediction of cardiovascular toxicity (CT) is an important part of the successful treatment and survival of patients.

Objective: to develop a risk score model for cardiovascular toxicity (CT) predicting, based on cardiovascular risk factors (RFs), RFs associated with cancer therapy, and troponin levels.

Material and methods: The study included 76 BC patients with a prospective analysis of their clinical and treatment data, RFs, echocardiographic indicators before the start of treatment and after 6 months, and an increase in troponin level. Among all RFs, the most significant RFs of CT were: radiation therapy, treatment with anthracyclines, and cardiovascular diseases. Based on the obtained results, a combined CT risk score was developed and proposed.According to the sum of points, patients were divided into groups: group 1 - with a low risk of CT development, the sum of points < 5; group 2 - moderate risk, 6-7 points; group 3 - high risk, > 8 points.

Results: In a pilot prospective study, an analysis of the RFs of CT was provided, compared to echocardiography data and the degree of troponin increase in dynamic observation; the risk score model for the CT prediction was developed for BC patients stratification. According to the developed score, BC patients with a total of > 8 points are considered to have a high risk of CT complications.

Conclusions: The use of the proposed risk model score with calculation of the RFs of CT along with high-sensitivity troponin increase during cancer treatment allows predicting the risk of CT developing at the early stages - before the onset of clinical manifestations. Accordingly, these BC patients have a high risk of CT, and the use of personalized cardiac monitoring together with cardioprotective therapy can prevent cardiovascular complications.

预测乳腺癌心脏毒性的风险评分模型:高敏感心肌肌钙蛋白 t 的诊断价值。
心血管疾病是乳腺癌(BC)患者的第二大死因。心血管毒性(CT)预测是患者成功治疗和生存的重要组成部分。目的:根据心血管危险因素(RFs)、与癌症治疗相关的RFs以及肌钙蛋白水平,建立心血管毒性(CT)预测风险评分模型:研究纳入了 76 名 BC 患者,对他们的临床和治疗数据、RFs、治疗开始前和 6 个月后的超声心动图指标以及肌钙蛋白水平的升高进行了前瞻性分析。在所有RFs中,CT最重要的RFs是:放射治疗、蒽环类药物治疗和心血管疾病。根据所得结果,制定并提出了CT风险综合评分。根据分数总和,将患者分为以下几组:第1组--CT发生风险低,分数总和小于5分;第2组--中度风险,6-7分;第3组--高风险,大于8分:在一项试验性前瞻性研究中,通过与超声心动图数据和动态观察中肌钙蛋白的升高程度进行比较,对 CT 的 RFs 进行了分析;为 BC 患者的分层建立了 CT 预测风险评分模型。根据所制定的评分标准,总分大于 8 分的 BC 患者被认为具有 CT 并发症的高风险:结论:使用所提出的风险模型评分,计算癌症治疗期间 CT 的 RFs 以及高敏肌钙蛋白的升高,可以在早期阶段--临床表现出现之前--预测发生 CT 的风险。因此,这些 BC 患者发生 CT 的风险很高,使用个性化心脏监测和心脏保护疗法可以预防心血管并发症。
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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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