Cardio-oncology最新文献

{"title":"Survival in patients with monoclonal gammopathy of unknown significance after transcatheter aortic valve replacement: a global retrospective propensity-matched real-world analysis.","authors":"Lorenz Oelschläger, Dominik Rebafka, Christian Frerker, Thomas Stiermaier, Jan Morf, Jan Vorwerk, Anna Traub, Theo Leitner, Nikolas von Bubnoff, Cyrus Khandanpour, Ingo Eitel","doi":"10.1186/s40959-026-00456-4","DOIUrl":"10.1186/s40959-026-00456-4","url":null,"abstract":"<p><p>BACKGROUND: Hematopoietic clonal disorders have previously been associated with cardiac diseases. Higher incidences of aortic valve stenosis have been observed not only in clonal hematopoiesis of indeterminate potential (CHIP) but also in monoclonal gammopathy of unknown significance (MGUS). However, studies investigating the outcome after transcatheter aortic valve implantation (TAVI) in MGUS are lacking. OBJECTIVE: Investigate overall survival in MGUS patients after TAVI. METHODS: We used the federated real-world data platform TriNetX to identify MGUS patients undergoing TAVI. Patients were divided into cohorts based on presence of MGUS, age or comorbidities and matched using the TriNetX propensity score matching tool. Overall survival was assessed after 1, 3 and 5 years. RESULTS: We identified 58,796 patients with TAVI procedure. Of these, 1039 patients (1.8%) were identified with co-occurring MGUS. Our study shows superior overall survival for patients without MGUS after TAVI in the overall cohort (HR:0.792 CI95% 0.657, 0.954, p = 0.014) and > 75 years of age (HR:0.797, CI95% 0.660, 0.961, p = 0.017) at the 5-year timepoint. 5-year overall survival did not differ in younger MGUS patients (< 75 years) or patients with co-occurring chronic kidney disease, chronic obstructive pulmonary disease or heart failure (p > 0.05). CONCLUSION: In this real-world analysis in patients with MGUS undergoing TAVI, MGUS was associated with inferior outcomes after TAVI, especially for older (> 75 years) patients. Five-year overall survival did not differ among patients with common comorbidities. Our results suggest that MGUS may be linked to worse overall long-term survival following TAVI and highlights the need for further interdisciplinary cardiooncology research. Given the key methodological limitations, the present results should be considered as hypothesis-generating. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardioprotective strategies of ACEi/ARBs and beta-blockers against anthracycline-induced cardiotoxicity in pediatric cancer survivors: a systematic review.","authors":"Reza Sattarpour, Maryam Noori","doi":"10.1186/s40959-026-00447-5","DOIUrl":"10.1186/s40959-026-00447-5","url":null,"abstract":"<p><p>BACKGROUND: Anthracyclines are routinely used in pediatric oncology but cause dose-dependent cardiotoxicity that compromises long-term survival. Neurohormonal agents such as ACE inhibitors (ACEi), angiotensin receptor blockers (ARBs), and beta-blockers have been suggested as preventive or therapeutic agents, yet evidence in children remains limited. Present review aimed to synthesize available data on their efficacy and safety among this population. METHOD: A systematic search of PubMed, Scopus, and Web of Science was conducted from inception to August 2025. Eligible studies included pediatric cancer survivors exposed to anthracyclines who received ACEi, ARBs, or beta-blockers with reported cardiac outcomes. Data extraction and risk-of-bias assessments were performed independently by two reviewers. Findings were synthesized narratively owing to study heterogeneity. FINDINGS: Sixteen studies met inclusion criteria, comprising nine RCTs, three observational studies, two case series, and two case reports. ACEi, mainly enalapril and captopril, were associated with attenuation of left ventricular ejection fraction (LVEF) decline and reduced biomarker elevations, although long-term benefits were inconsistent and side effects such as hypotension were reported. Beta-blockers, particularly carvedilol, improved ventricular function, strain indices, and clinical symptoms in several studies, though the largest trial (PREVENT-HF) did not show significant benefit on primary remodeling outcomes, except in high-risk subgroups. Overall, the evidence suggests that while preventive use of ACEi/ARBs and beta-blockers shows more consistent benefits, findings regarding their role in reversing established cardiotoxicity remain variable and should be interpreted cautiously. CONCLUSION: ACEi/ARBs and beta-blockers showed promise in preventing or mitigating anthracycline-induced cardiotoxicity among children, with consistent benefits on surrogate outcomes but uncertain durability and survival impact. Early initiation and targeted use in high-risk patients appear most advantageous, underscoring the need for large biomarker-guided trials to refine prevention strategies. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of cardiotoxicity assessed with CZT-ERNA in patients undergoing contemporary cancer therapy: a 12-year real-world experience.","authors":"Johan Erik Larsson, Marc Østergaard Nielsen, Bo Zerahn","doi":"10.1186/s40959-026-00457-3","DOIUrl":"10.1186/s40959-026-00457-3","url":null,"abstract":"<p><p>BACKGROUND: Cancer therapy has undergone a remarkable transformation over recent decades with the addition of new therapeutic modalities. Nonetheless, adverse effects remain significant, and contemporary real-world data on the incidence and risk factors for cardiotoxicity, as assessed using cadmium-zinc-telluride (CZT) equilibrium radionuclide nuclear angiography (ERNA), remain limited. METHODS: We included all adult patients who underwent first-time and follow-up assessment of cardiac function with CZT-ERNA within 6 months in relation to cancer therapy at Copenhagen University Hospital – Herlev between 2012 and 2024. The primary outcome was cardiotoxicity, defined as a ≥ 10% reduction in left ventricular ejection fraction (LVEF) from baseline to < 50% during the first year, and was estimated using cumulative incidence functions. Secondary outcomes were LVEF recovery to ≥ 50%, and risk factors for cardiotoxicity. Risk factors were estimated with multiple logistic regression. RESULTS: Of 6,299 patients examined, 2,345 adult patients (70% females, median age 61 years, Q1-Q3 50–71) had a first-time assessment with CZT-ERNA and ≥ 1 follow-up assessment within 6 months, with a total of 9,135 examinations during the first year. Most patients had breast cancer (46%), sarcoma (19%), and melanoma (15%). The overall incidence of cardiotoxicity was 12.3% (95% CI 10.9%-13.6%) and occurred in 278 patients. Median time to cardiotoxicity was 149 days [Q1-Q3 90–236 days] and reversibility was observed in 185 patients (67%). Baseline LVEF (adjusted OR / 10% increase 0.43; 95% CI 0.37–0.50; p < 0.0001), end-systolic volume (adjusted OR / 10 ml increase 1.51; 95% CI 1.38–1.66; p < 0.0001), end-diastolic volume (adjusted OR / 10 ml increase 1.14; 95% CI 1.07–1.21; p < 0.0001), heart rate (adjusted OR / 10 beats per minute increase 1.25; 95% CI 1.12–1.39; p < 0.0001), and body mass index (BMI) (adjusted OR / unit higher 0.97 (95% CI 0.94-1.00; p = 0.03) were associated with cardiotoxicity, whereas systolic blood pressure was not (adjusted OR / 10 mmHg increase 0.95; 95% CI 0.87–1.04; p = 0.25). CONCLUSION: Cardiotoxicity occurred in approximately 12% of all cancer patients referred for CZT-ERNA surveillance during cancer therapy. Patients with larger left ventricular volumes, lower LVEF, and higher heart rate at baseline may require specific attention. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of patients with systemic light chain amyloidosis treated with DVD front-line therapy.","authors":"Jinghua Wang, Mengyuan Li, Pengjun Liao, Jiaqi Tan, Lingji Zeng, Shengcai Liu, Ping Wu, Piaorong Zeng, Jianyu Weng, Xin Du, Liye Zhong, Peilong Lai","doi":"10.1186/s40959-026-00446-6","DOIUrl":"10.1186/s40959-026-00446-6","url":null,"abstract":"<p><p>A substantial proportion of patients are unsuitable candidates for the Dara-CyBorD regimen (daratumumab-cyclophosphamide-bortezomib-dexamethasone), the standard frontline treatment for systemic amyloid light-chain (AL) amyloidosis as established in the ANDROMEDA clinical trial. This is primarily due to their severe organ dysfunction and limited treatment tolerance. In this work, we evaluated an alternative frontline regimen of DVD (daratumumab-bortezomib-dexamethasone) in 64 newly diagnosed patients with AL amyloidosis, including those with advanced cardiac disease. The best hematologic response achieved was a complete response (CR) in 56.3% of patients, with very good partial response (VGPR) or better observed in 68.8%, not inferior to the hematologic responses reported in the ANDROMEDA trial. At 6 months, 13 (48.1%) achieved a cardiac response and 17 (85.0%) achieved a renal response, compared favourably to the data in ANDROMEDA. Notably, the incidence of grade ≥ 3 infections was 1.6%, significantly lower than the 7.8% reported in ANDROMEDA. The estimated 1- and 2-year overall survival (OS) rates were 84.4% and 82.8%, respectively. The profound hematologic response rates (VGPR/CR) in mayo stage IIIB patients were comparable to those in mayo stage I-IIIA patients, while the median OS of stage IIIB patients was significantly shorter than that of stage I-IIIA patients. No therapy-related deaths or permanent treatment discontinuation due to toxicity were observed. Overall, our findings demonstrate that the DVD regimen is both effective and well-tolerated, even in patients with advanced cardiac involvement.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":"34"},"PeriodicalIF":3.4,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxaliplatin-induced cardiotoxicity in mice is connected to the changes in energy metabolism in the heart tissue.","authors":"Junwei Du, Leland C Sudlow, Kiana Shahverdi, Haiying Zhou, Megan S Michie, Thomas H Schindler, Joshua D Mitchell, Shamim Mollah, Mikhail Y Berezin","doi":"10.1186/s40959-026-00453-7","DOIUrl":"10.1186/s40959-026-00453-7","url":null,"abstract":"<p><p>Oxaliplatin is a platinum-based alkylating chemotherapeutic agent used for cancer treatment. At high cumulative dosage, the negative effect of oxaliplatin on the heart becomes evident and is linked to a growing number of clinical reports. The aim of this study was to determine how chronic oxaliplatin treatment causes the changes in energy-related metabolic activity in the heart that leads to cardiotoxicity and heart damage in mice. C57BL/6 male mice were treated with a human equivalent dosage of intraperitoneal oxaliplatin (0 and 10 mg/kg) once a week for eight weeks. During the treatment, mice were followed with ECG, histology and RNA sequencing of the heart. We identified that oxaliplatin induces strong changes in the heart and affects the heart's energy-related metabolic profile. Histological post-mortem evaluation identified focal myocardial necrosis infiltrated with a small number of associated neutrophils. Accumulated doses of oxaliplatin led to significant changes in gene expression related to energy related metabolic pathways including fatty acid (FA) oxidation and glycolysis leading to the glycolysis switch. Our study can be used for the development of diagnostic methods to detect oxaliplatin-induced cardiotoxicity at an early stage and identifying therapeutic methods to minimize heart failure.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of cardiovascular-kidney-metabolic syndrome stages with long-term mortality among US cancer survivors: a prospective cohort study.","authors":"Yangyang Zheng, Ting Li, Jinghai Song","doi":"10.1186/s40959-026-00450-w","DOIUrl":"10.1186/s40959-026-00450-w","url":null,"abstract":"<p><p>INTRODUCTION: Cardiovascular-Kidney-Metabolic (CKM) syndrome is common among cancer survivors, largely driven by overlapping risk factors and therapy-induced toxicities; however, its contribution to long-term mortality has not been clarified. METHODS: From the 1999–2018 National Health and Nutrition Examination Survey (NHANES) cycles, 2,274 cancer survivors with CKM syndrome stages 1–4 were included. Associations between CKM syndrome staging and long-term mortality were analyzed using weighted Cox regression, and further explored through subgroup and sensitivity analyses. RESULTS: During a median follow-up of 10.2 years, 854 deaths occurred (277 cancer-related, 224 cardiovascular). Higher CKM stages were associated with increased all-cause and cardiovascular mortality, but not cancer-specific mortality. Adjusted HRs (95% CIs) for all-cause mortality were 1.215 (95% CI: 0.757–1.950) for stage 2, 1.772 (95% CI: 1.089–2.885) for stage 3, and 2.560 (95% CI: 1.597–4.103) for stage 4; for cardiovascular mortality, HRs were 1.406 (95% CI: 0.582–3.393), 2.910 (95% CI: 1.108–7.644), and 5.960 (95% CI: 2.158–16.458). CONCLUSION: Progression of CKM syndrome was linked to increased all-cause and cardiovascular mortality among cancer survivors, underscoring the need for early recognition and intervention. TRIAL REGISTRATION: Not applicable. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":"33"},"PeriodicalIF":3.4,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular signaling proteins as predictors of the cardiac effects of doxorubicin treatment in children with acute lymphoblastic leukemia.","authors":"Steven E Lipshultz, Holly M Smith, Stephen E Sallan, Douglas B Sawyer","doi":"10.1186/s40959-026-00454-6","DOIUrl":"10.1186/s40959-026-00454-6","url":null,"abstract":"<p><strong>Background: </strong>Cardiac signaling proteins sensitive to changes in cardiac status may help predict the cardiac effects of doxorubicin in children with acute lymphoblastic leukemia (ALL). We determined the relationship between these proteins and biomarkers of cardiac injury and echocardiographic characteristics.</p><p><strong>Methods: </strong>Cardiotrophin-1 (CT-1), interleukin-6 (IL-6), neuregulin-1 (NRG-1), and vascular endothelial growth factor (VEGF) concentrations were measured in 83 children on Dana-Farber Cancer Institute ALL Protocol 95 - 01 before, during (T1: 0-50 days, T2: 51-100 days, T3: 151-300 days), and after treatment and compared to existing data for cardiac troponin-T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), and echocardiograms.</p><p><strong>Results: </strong>Compared to baseline, mean IL-6 concentrations were lower during doxorubicin treatment (P < 0.01 for all) and after (P = 0.03). Mean NRG-1 and CT-1 concentrations were significantly lower beginning at T2 and thereafter (P < 0.001 for all). Mean VEGF concentrations were significantly elevated from baseline at all on-treatment time points (P ≤ 0.02 for all). Lower odds of abnormal cTnT were marginally associated with increased NRG-1. Higher odds of abnormal NT-proBNP were associated with CT-1 concentrations (P = 0.03) and marginally associated with increased IL-6 and NRG-1 concentrations. Increased hsCRP concentrations were associated with increased IL-6, NRG-1, and CT-1 (P < 0.001 for all). No echocardiographic measurements were associated with signaling proteins.</p><p><strong>Conclusions: </strong>Decreased concentrations CT-1 and NRG-1 during doxorubicin treatment may increase cardiomyocyte death. Changes in IL-6 and VEGF suggest doxorubicin-related inflammation and angiogenesis. These markers may help identify children at greatest risk of long-term adverse outcomes.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of cardiac amyloidosis on patients with multiple myeloma: a systematic review and meta-analysis.","authors":"Giuseppina Novo, Francesco Stabile, Daniela Di Lisi, Cristina Madaudo, Sebastian Jaramillo, Francesco Damiani, Christian Orilia, Massimiliano Camilli, Sergio Buccheri, Peter van Der Meer, Alfredo Ruggero Galassi, Alexander R Lyon","doi":"10.1186/s40959-025-00435-1","DOIUrl":"10.1186/s40959-025-00435-1","url":null,"abstract":"<p><p>BACKGROUND: Immunoglobulin light chain (AL) amyloidosis is a well-recognized complication of multiple myeloma (MM), with important prognostic implications. However, the effect of cardiac AL amyloidosis on survival in MM patients has been rarely investigated. OBJECTIVE: We aimed to perform a systematic review and meta-analysis to quantitatively assess the prognosis of MM patients with and without concomitant cardiac AL amyloidosis. METHODS: We searched PubMed, Scopus and Cochrane databases for studies comparing the survival of MM patients with and without concomitant cardiac AL amyloidosis. The primary outcome was all-cause mortality at 12 months (short-term), while secondary outcomes included all-cause mortality at 24 and 36 months (long-term). We also reconstructed individual patient data (IPD) from Kaplan–Meier curves to estimate Restricted Mean Survival Time (RMST). We pooled risk ratios (RR) with 95% confidence intervals (CI) using a random-effects model. RESULTS: We included five studies encompassing 272 patients, of whom 110 (40%) presented MM with concomitant cardiac AL amyloidosis. All-cause mortality at 12 months was nearly five times higher in MM patients with cardiac involvement compared to those without cardiac involvement (RR 4.25; 95% CI 1.99–9.04; p = 0.0002). This trend remained consistent at long-term follow-up, with increased mortality observed in patients with cardiac involvement at 24 months (RR 1.84; 95% CI 1.19–2.84; p = 0.006) and 36 months (RR 1.78; 95% CI 1.26–2.52; p = 0.001. RMST was 27.28 months shorter in patients with cardiac involvement (p < 0.0001). CONCLUSION: These finding show that Cardiac AL amyloidosis is a major determinant of survival in MM patients. These findings should be interpreted in the context of the moderate risk of bias and heterogeneity of the available observational evidence. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":"32"},"PeriodicalIF":3.4,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of acute coronary syndrome on long-term survival in cancer patients.","authors":"Daniel Finke, Markus B Heckmann, Jessica M Schug, Lukas F Entenmann, Hauke Hund, Hugo A Katus, Norbert Frey, Lorenz H Lehmann","doi":"10.1186/s40959-026-00451-9","DOIUrl":"10.1186/s40959-026-00451-9","url":null,"abstract":"<p><p>BACKGROUND: Although cancer and atherosclerosis are based on shared risk factors, the impact of the acute coronary syndrome (ACS) on long-term survival in cancer patients is still unclear. METHODS: We retrospectively analyzed 441 patients with initial diagnosis of cancer prior to ACS who were subjected to cardiac catheterization (CC) with a follow-up of at median 4.78 years (IQR: 0.58–9.33). These patients were compared to non-cancer ACS patients via propensity score matching according to the cardiac risk factors age, sex, arterial hypertension and diabetes. RESULTS: We found ACS, and overall Non-ST-elevation myocardial infarction (NSTEMI), as a relevant predictor of outcome in cancer patients with the highest mortality rates (88 deaths (40%) in non-cancer patients with NSTEMI vs. 174 deaths (64.9%), in the respective cancer patients p < 0.001). In multivariable COX models including other comorbidities, cancer was found to independently influence mortality as well as cardiovascular hospital readmission (HR all-cause mortality: 1.47, p < 0.001, HR readmission: 1.54, p < 0.001). Other risk factors, such as renal dysfunction, diabetes or impaired left ventricular function showed comparable influence on mortality. Percutaneous coronary intervention (PCI) rates did not differ between the groups (228/441 non-cancer patients (51.7%) vs. 227/441 cancer patients (51.5%), p = 0.95), but optimized medical treatment was less present in the cancer group. In a subgroup of cancer patients with available biomarker data, NT-proBNP, but not hs-cTnT, was found to be useful for risk stratification (HR univariate: 1.28, HR multivariate considering risk factors and hs-cTnT: 1.26, p < 0.001 . CONCLUSIONS: Our data indicate a relevant effect of ACS, especially NSTEMI, in cancer patients with impact on long-term mortality and cardiac morbidity. Cancer patients with NSTEMI warrant special care, considering comorbidities and optimized medical treatment of the cardiac disease. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":"35"},"PeriodicalIF":3.4,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in circulating miR-199a, cardiac troponin I, NT-proBNP, and left ventricular ejection fraction during anthracycline therapy in breast cancer patients.","authors":"Shaghayegh Kamian, Payam Azadeh, Robab Anbiaee, Ahmad Mafi, Hasan Ashoori, Hamed Ghoshouni, Mohammad Javad Bahadori, Tannaz Malakouti","doi":"10.1186/s40959-026-00448-4","DOIUrl":"10.1186/s40959-026-00448-4","url":null,"abstract":"<p><p>BACKGROUND: Anthracyclines are widely used in the treatment of breast cancer but are associated with myocardial injury that may progress to cardiac dysfunction. Surveillance has traditionally relied on left ventricular ejection fraction (LVEF), which may not detect early subclinical injury. Circulating biomarkers, including cardiac troponin I (cTnI), NT-proBNP, and microRNAs such as miR-199a, have been proposed as potential early indicators of anthracycline-related myocardial injury. This study aimed to exploratorily evaluate early biomarker changes during anthracycline therapy and their relationship to short-term LVEF variability. METHODS: In this single-center prospective observational study, women with non-metastatic breast cancer receiving anthracycline-based chemotherapy were enrolled between April 2022 and May 2024. Cardiac biomarkers (cTnI, NT-proBNP, and plasma miR-199a) and echocardiographic LVEF were assessed at baseline and after four cycles of dose-dense doxorubicin/cyclophosphamide. Within-patient changes were analyzed using Wilcoxon signed-rank tests. Associations between changes in biomarkers, LVEF, and cumulative doxorubicin dose were assessed using Spearman’s rank correlation. Exploratory subgroup analyses were performed based on the presence or absence of any absolute LVEF decrease. RESULTS: Forty-eight patients were enrolled, and 45 with complete paired data were included in the final analyses (mean age 41.4 ± 11.6 years). cTnI and plasma miR-199a levels increased significantly following chemotherapy (both p < 0.001), whereas NT-proBNP showed no significant change. Median LVEF remained unchanged at the cohort level and was not significantly correlated with changes in cTnI, NT-proBNP, or miR-199a. Cumulative doxorubicin dose was inversely correlated with change in LVEF (ρ = −0.424, p = 0.004). CONCLUSIONS: In this prospective cohort of breast cancer patients treated with anthracycline-based chemotherapy, circulating cTnI and miR-199a increased early during treatment, while cohort-level LVEF remained stable over short-term follow-up. Changes in these biomarkers were not associated with contemporaneous changes in LVEF, whereas higher cumulative anthracycline exposure was associated with a modest reduction in LVEF. </p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}