Abstract 17234: Comparing the Efficacy of Primary Prevention Strategies in Doxorubicin-induced Cardiotoxicity using Echocardiography and High-Sensitivity Troponin T
Introduction: Detection of chemotherapy-induced cardiotoxicity has historically relied on clinical presentation and cardiac imaging measures. Recently, global longitudinal peak systolic strain (GLS) measures with speckle tracking echocardiography (STE) and high-sensitivity troponin T (hs-TnT) have been utilized to evaluate the development of cardiotoxicity. The increased sensitivity of these methods may allow us to differentiate the relative difference in efficacy amongst primary prevention strategies.
Hypothesis: We tested the hypothesis that GLS or hs-TnT will differentiate the efficacy between dexrazoxane and continuous infusion of doxorubicin in preventing doxorubicin-induced cardiotoxicity.
Methods: Twenty-three patients with newly diagnosed sarcoma were assigned to receive 72-hours doxorubicin infusion (13 patients) or doxorubicin + dexrazoxane injection (10 patients). hs-TnT was monitored before, at 24 and 72 hours of each chemotherapy cycle. All samples were assayed at the same time using hs-TnT (Roche diagnostics). Elevated troponin is defined as hs-TnT > 5 ng/L. STE was performed pretreatment, after cycle 3 and cycle 6 of chemotherapy. Only patients who received ≥ 150 mg/m2 of doxorubicin and had at least 2 STE were included for evaluation of GLS and ejection fraction (EF).
Results: There was no statistical difference between 2 groups in term of sex, dose of doxorubicin and cardiac risk factors, however, patients in dexrazoxane group were older (p < 0.01). A total of 227 measurements of hs-TnT were obtained (118 samples from continuous infusion and 109 from dexrazoxane group). The patients with pretreatment elevation of hs-TnT were not significantly different (p=0.62). Elevation of hs-TnT was more frequent in dexrazoxane group (56.9%) compared to continuous infusion (26.3%), p < 0.01. Ten patients (76.9%) in continuous infusion did not have any troponin elevation after treatment, compared to three patients (30%) in dexrazoxane group (p=0.04). There were no significant changes in GLS and EF after treatment in both groups, p > 0.05.
Conclusions: Continuous infusion was more effective than dexrazoxane in preventing doxorubicin-induced elevations of hs-TnT. However, differences in EF and GLS were not detected.
Author Disclosures: P. Vejpongsa: None. M. Chen: None. D.M. Araujo: None. M.R. Massey: None. J. Banchs: None. S.A. Acholonu: None. S.A. Hassan: None. Q.H. Meng: None. E.T. Yeh: None.
- © 2014 by American Heart Association, Inc.