Association of test levels of cardiac damage and metalloproteinases with the development of anthracycline-induced cardiotoxicity in patients with breast malignancies 12 months after the end of chemotherapy

   Aim. To estimate the level of cardiac biomarkers and metalloproteinases (MMPs) in breast cancer patients’ plasma 12 months after the end of chemotherapy (CT) with doxorubicin; to determine the relationship between changes in their level and the occurrence of early cardiotoxicity (CT) taking into account arterial hypertension (AH) and the prescription of cardiotropic therapy (CTT).

   Materials and methods. The study involved patients with a confirmed diagnosis of breast cancer. Before and 12 months after the end of chemotherapy, the level of MMPs and cardiac markers in blood plasma were determined using the enzyme immunoassay method.

   Results. A statistically significant increase in the level of cardiac troponins (TnI, TnT) and a decrease in NT-proBNP in the CT+ and CT- subgroups 12 months after the end of chemotherapy with doxorubicin were revealed. Differences between CT+ and CT- were detected only for TnI hs (2.8 times, p = 0.011). In the CTT+ subgroup, no statistically significant differences were observed between the level of the studied parameters in KT+ and KT-. The differences identified without taking into account CTT remained in the subgroup of CTT- patients. The level of TnI hs in CT+ and CTT+ patients was lower (median 6.7 pg/ml) compared to KT+ and KTT- (median 16.8 pg/ml). An increase in the level of MMP-2 and a decrease in MMP-9 and MMP-3 were observed in patients in the CT+ and CT- subgroups. The median values of MMP-3 level in the CT+ subgroup were statistically significantly lower than those in the CT- subgroup by 16.6 % (p = 0.021). In CTT+ there were no statistically significant differences between the level of MMP in CT+ and CT-, but in case of CTT- the level of MMP-3 was statistically significantly different in the CT+ and CT- subgroups. There was no relationship between the level of MMP and hypertension before the start of chemotherapy.

   Conclusion. An increased level of plasma TnI hs and a decreased level of plasma MMP-3 12 months after the end of chemotherapy hold the potential to reveal the early signs of CT. The sensitivity and specificity of potential markers increase in patient groups not receiving CTT. It was confirmed that there was no connection between the presence of hypertension in patients, the level of the studied biochemical parameters and CT.

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