Early Cardiac Biomarkers for the Detection of Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer: A Systematic Review and Meta-Analysis
4 affiliations
- 1Department of Biomedical Sciences, School of Medicine, Nazarbayev University, 5/1 Kerey and Zhanibek Khandar str., Astana 010000, Kazakhstan
- 2Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa 13133, Jordan
- 3Institute of Medical Science Technology [UniKL MESTECH], Universiti Kuala Lumpur, A1-1, Jalan TKS 1, Taman Kajang Sentral, Kajang 43000, Selangor, Malaysia
- 4National Laboratory Astana, Center of Life Sciences, Nazarbayev University, Astana 010000, Kazakhstan
Abstract
Background/Objectives: Chemotherapy-induced cardiotoxicity is a serious complication in breast cancer treatment, particularly with anthracyclines and HER2-targeted therapy. To evaluate the association between early elevations of cardiac markers (troponin and NT-proBNP) and the development of chemotherapy-induced cardiotoxicity in adult patients with breast cancer. Methods: This systematic review and meta-analysis were conducted according to PRISMA guidelines and registered with PROSPERO (CRD420261301170). A systematic search of PubMed/MEDLINE, Cochrane CENTRAL, and Web of Science databases was conducted. Studies evaluating cardiac markers in breast cancer patients receiving chemotherapy were included in the review. Results: Fourteen studies were included in the qualitative synthesis. Five studies were included in the meta-analysis. Elevated troponin levels were associated with higher odds of subsequent cardiac dysfunction; however, the pooled association was not statistically significant [OR = 3.40, 95% CI 0.69–16.67, p = 0.13] and showed substantial heterogeneity [I2 = 86.97%]. A leave-one-out sensitivity analysis was used to identify a study that exerted a substantial influence; its exclusion eliminated between-group heterogeneity and attenuated the pooled effect estimate. Conclusions: Early troponin elevation may provide a biological signal of myocardial injury during cancer therapy. However, the association between elevated troponin level and cancer therapy-related cardiac dysfunction did not reach the threshold of statistical significance and showed substantial heterogeneity. Troponin and NT-proBNP may provide complementary information to cardiac imaging, but their predictive performance and clinical utility require further prospective validation.
Related
- Cardiovascular Magnetic Resonance for Early Detection of Cancer Therapy-Related Cardiac Dysfunction: From Multiparametric Tissue Signatures to Clinical Pathways
- Multi-modal AI: Integrating electrocardiography with molecular biomarkers for noninvasive detection of cardiac allograft rejection
- "Et tu, Brute?" - A Case of Ixazomib - Induced Cancer Therapy-related Cardiac Dysfunction
- Early Lymphocyte Dynamics and Subsequent Cancer Therapy-Related Cardiac Dysfunction in Patients Receiving Anthracycline Therapy
- Trial sequential analysis of the efficacy of amino acid and protein therapy in preventing cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis
BibTeX
@article{askambayeva2026early,
title = {{Early Cardiac Biomarkers for the Detection of Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer: A Systematic Review and Meta-Analysis}},
author = {Nazym Askambayeva and Zhuldyz Myrzabay and Ahmad J. Harahsheh and Reezal Ishak and Aigerim Biniyazova and Mohamad Aljofan},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207882},
url = {https://www.mdpi.com/2077-0383/15/20/7882},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Early Cardiac Biomarkers for the Detection of Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer: A Systematic Review and Meta-Analysis
AU - Nazym Askambayeva
AU - Zhuldyz Myrzabay
AU - Ahmad J. Harahsheh
AU - Reezal Ishak
AU - Aigerim Biniyazova
AU - Mohamad Aljofan
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207882
UR - https://www.mdpi.com/2077-0383/15/20/7882
AB - Background/Objectives: Chemotherapy-induced cardiotoxicity is a serious complication in breast cancer treatment, particularly with anthracyclines and HER2-targeted therapy. To evaluate the association between early elevations of cardiac markers (troponin and NT-proBNP) and the development of chemotherapy-induced cardiotoxicity in adult patients with breast cancer. Methods: This systematic review and meta-analysis were conducted according to PRISMA guidelines and registered with PROSPERO (CRD420261301170). A systematic search of PubMed/MEDLINE, Cochrane CENTRAL, and Web of Science databases was conducted. Studies evaluating cardiac markers in breast cancer patients receiving chemotherapy were included in the review. Results: Fourteen studies were included in the qualitative synthesis. Five studies were included in the meta-analysis. Elevated troponin levels were associated with higher odds of subsequent cardiac dysfunction; however, the pooled association was not statistically significant [OR = 3.40, 95% CI 0.69–16.67, p = 0.13] and showed substantial heterogeneity [I2 = 86.97%]. A leave-one-out sensitivity analysis was used to identify a study that exerted a substantial influence; its exclusion eliminated between-group heterogeneity and attenuated the pooled effect estimate. Conclusions: Early troponin elevation may provide a biological signal of myocardial injury during cancer therapy. However, the association between elevated troponin level and cancer therapy-related cardiac dysfunction did not reach the threshold of statistical significance and showed substantial heterogeneity. Troponin and NT-proBNP may provide complementary information to cardiac imaging, but their predictive performance and clinical utility require further prospective validation.
SN - 2077-0383
ER -