Sodium-Glucose Co-Transporter-2 Inhibitors and Cardiac Outcomes Among Patients Treated With Anthracyclines

Góngora, Carlos; Drobni, Zsófia; Silva, Thiago Quinaglia Araujo Costa; Zafar, Amna; Gong, Jingyi; Zlotoff, Daniel A.; Gilman, Hannah; Hartmann, Sarah; Sama, Supraja; Nikolaidou, Sofia; Suero-Abreu, Giselle Alexandra; Jacobsen, Eric N.; Abramson, Jeremy S.; Hochberg, Ephraim P.; Barnes, J. R.; Armand, Philippe; Thavendiranathan, Paaladinesh; Nohria, Anju; Neilan, Tomas G.

doi:10.1016/j.jchf.2022.03.006

Cited by 66 publications

(36 citation statements)

References 37 publications

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“…15 Our result may well support the recommendation to measure the hsTnT of patients who are to receive the amount of anthracycline, and they may be considered to start monthly follow-ups of echocardiography for the subsequent 3 months in order to start cardioprotective agents and even SGLT2 inhibitor, which is suggested to be effective in preventing the decline of LV function by emerging results. 32 In facilities, acquiring reliable GLS is di cult; hence, hsTnT is undoubtedly a reliable biomarker to detect patients, especially those categorized as low-risk, who need to be referred for close cardiac surveillance. Highly-sensitive cardiac troponin can also contribute to populations for whom obtaining echocardiographic images of su cient quality for analysis is challenging.…”

Section: Discussionmentioning

confidence: 99%

Investigation of biomarker-based follow-up of anthracycline-induced cardiotoxicity in patients with breast cancer based on the latest protocol from the European Society of Cardiology guideline on cardio-oncology

Katsumata

Hayashida

et al. 2023

Preprint

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Background Anthracyclines are commonly used for the treatment of solid tumors and hematological malignancies because of their inevitable dose-dependent cardiotoxic effects. The study aimed to assess the feasibility of applying a biomarker-based surveillance strategy according to European guidelines for the early prediction of anthracycline-induced cardiotoxicity in patients with breast cancer.Methods From April 2018 to December 2021, 45 women with breast cancer (53.9 ± 11.0 years) treated with anthracycline-based regimens were evaluated for 1 year. We measured and analyzed high-sensitivity cardiac troponin T (hsTnT), B-type natriuretic peptide (BNP), global longitudinal strain (GLS), and left ventricular ejection fraction (LVEF) at baseline, and 3 and 6 months after the initiation of anthracycline-based chemotherapy. Cardiotoxicity was defined as a reduction in LVEF > 10% compared with baseline to LVEF < 53%, or a decline in GLS > 15% from baseline.Results After initiating anthracycline treatment, hsTnT levels peaked at 3 months, whereas BNP levels were the highest at 6 months. Cardiotoxicity was detected in 18 (20.0%) patients (one patient with LVEF decline), where GLS declined over time yet became significant only after 6 months. Elevated hsTnT at 3 months were significantly associated with a GLS decline at 6 months (P < 0.001, Youden index 0.009 g/mL increase from baseline; sensitivity and specificity were 100% and 80.5%, respectively). In contrast, changes in BNP were not associated with changes in LVEF or GLS. No symptomatic heart failure occurred within 1 year of chemotherapy.Conclusions Among patients with early-stage breast cancer, an increase in hsTnT at 3 months after initiation of the anthracycline-based regimen predicted a subsequent decline in GLS with high sensitivity and moderate specificity.

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Section: Discussionmentioning

confidence: 99%

Investigation of biomarker-based follow-up of anthracycline-induced cardiotoxicity in patients with breast cancer based on the latest protocol from the European Society of Cardiology guideline on cardio-oncology

Katsumata

Hayashida

et al. 2023

Preprint

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“…Innovative therapies in cardiotoxicity prevention include statins, for which published results of a phase II trial are expected in 2023 31. While randomised controlled trials of sodium-glucose co-transporter-2 inhibitors at the time of anthracycline treatment are underway, real-world data suggest benefits, such as lower overall mortality 32…”

Section: Breast Cancer Treatments and Cvd Riskmentioning

confidence: 99%

Common origins and shared opportunities for breast cancer and cardiovascular disease prevention

Henry

Vaidean

Rege

et al. 2023

Heart

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“…Beide Substanzgruppen führen zu einer Besserung der linksventrikulären Funktion über einen Zeitraum von 6 Monaten [5]. und das Überleben steigern kann [6]. Prospektive Daten in Bezug auf die Wirkung von SGLT2-Inhibitoren zur Prävention oder Therapie der Anthrazyklin-assoziierten Kardiotoxizität sind jedoch bisher nicht verfügbar.…”

Section: Therapeutische Optionenunclassified

“…Eine präventive Anwendung zur Verhinderung einer linksventrikulären Dysfunktion kann bei sehr hoher Risikokonstellation diskutiert werden. Neue Daten zeigen, dass die Therapie mit einem SGLT2-Inhibitor (Sodium-Glucose Co-Transporter 2-Inhibitor) bei Patienten unter Anthrazyklin-Chemotherapie das Auftreten von kardialen Ereignissen verringert und das Überleben steigern kann 6 . Prospektive Daten in Bezug auf die Wirkung von SGLT2-Inhibitoren zur Prävention oder Therapie der Anthrazyklin-assoziierten Kardiotoxizität sind jedoch bisher nicht verfügbar.…”

Section: Anthrazyklin-chemotherapieunclassified

Medikamentös bedingte Kardiomyopathien

Michel¹,

Rassaf²

2022

Dtsch Med Wochenschr

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Kardiovaskuläre Nebenwirkungen medikamentöser Therapien haben einen signifikanten Einfluss auf die Morbidität und Mortalität von Patienten. Dieser Beitrag gibt eine Übersicht über wichtige Substanzgruppen mit kardiotoxischen Nebenwirkungen und fasst Prinzipien der Diagnostik und Therapie zusammen. Eine gute Kenntnis der Charakteristika spezifischer kardialer Nebenwirkungen kann dazu beitragen, die Behandlung von Patienten zu verbessern.

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Sodium-Glucose Co-Transporter-2 Inhibitors and Cardiac Outcomes Among Patients Treated With Anthracyclines

Cited by 66 publications

References 37 publications

Investigation of biomarker-based follow-up of anthracycline-induced cardiotoxicity in patients with breast cancer based on the latest protocol from the European Society of Cardiology guideline on cardio-oncology

Investigation of biomarker-based follow-up of anthracycline-induced cardiotoxicity in patients with breast cancer based on the latest protocol from the European Society of Cardiology guideline on cardio-oncology

Common origins and shared opportunities for breast cancer and cardiovascular disease prevention

Medikamentös bedingte Kardiomyopathien

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