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ABSTRACT: Objective: To look for a nearly ideal tool for prediction of anthracycline-induced cardiotoxicity. Method: Thirty-one patients with various hematological malignancies were included in the study which was conducted from Sept. 2005 to Sept. 2006 in Baghdad Teaching Hospital - Hematology Unit. Initial cardiovascular assessment including cardiac troponin I, electrocardiography and echocardiography were done and repeated one month after the commencement of anthracycline-based regimen. Cardiotoxicity was considered present if the patient has clinical and electrocardiographic evidences, troponin positivity, echocardiographic evidence, or any combination of these. Results: The mean age for the study sample was 34.1±17.2 years comprising of 17 male and 14 female patients. Increasing age, body surface area, anthracycline dose as well as the concomitant use of cyclophosphomide/All Trans Retinoic Acid were associated with increased risk of cardiotoxicity. The cut-off point of body surface area above which the risk of anthracycline-induced cardiotoxicity is increased was 1.88 m2 while the cut-off point for anthracyclines dose was 145.5 mg/m2. The constellation of clinical data, ECG, and cTnI was 92% predictive of early evidence of anthracycline-induced cardiotoxicity. More weight is added when echocardiography is used as a diagnostic tool. The incidence of cardiotoxicity attributed to treatment was 38.7%. The predictive power of cardiac troponin I alone was 58.3%, whereas it increases to 91% when combined with electrocardiography and to 95% when combined with echocardiographic study. Conclusion: The age, anthracyclines dose and the use of other chemotherapeutics increase the risk of anthracycline-induced cardiotoxicity. Cardiac troponin I is a simple non-invasive indicator for the presence of anthracycline-induced cardiotoxicity especially when used in combination with other parameters. Keywords: Anthracycline, Cardiotoxicity, Troponin.
gulf journal of oncology, The 07/2011; 1(10):33-9.