Journal of Cardiology Research and Endovascular Therapy
Prospective Role of N-terminal Pro-type B Natriuretic Peptide and Troponins Biomarkers for Early Detection of Cardiotoxicity in Cancer Survivors
Abstract
Izuchukwu Prince Nweke, Koya Babayemi Olajuwon, Konstantin Koshechkin
Cardiotoxicity remains a significant complication in cancer survivors receiving cardiotoxic therapies such as anthracyclines and HER2-targeted agents. Early detection of cardiac dysfunction is critical to prevent irreversible damage and optimize clinical outcomes. N-terminal pro-type B natriuretic peptide (NT-proBNP) and troponins, established cardiac biomarkers, have emerged as promising tools for the early identification of subclinical cardiotoxicity. This article reviews current evidence on the utility of NT-proBNP and troponins in prospective monitoring of cardiotoxic effects in cancer patients. Clinical trials, including the International Cardio-Oncology Society-one trial, highlight the prognostic value of these biomarkers in guiding preventive interventions such as enalapril therapy. Studies from registries like the Essen Cardio-Oncology Registry (ECoR) demonstrate the sensitivity and specificity of troponins and NT-proBNP for detecting early myocardial injury before symptomatic heart failure develops. Moreover, recent European Society of Cardiology (ESC) guidelines endorse the use of these biomarkers as part of comprehensive cardio-oncology risk assessment and management protocols. Despite some challenges in interpretation and variability, serial measurements of NT-proBNP and high-sensitivity troponins provide valuable, non-invasive insights into cardiac stress and injury related to chemotherapy. This review synthesizes findings from landmark studies and guidelines, supporting the integration of NT-proBNP and troponins into routine surveillance strategies to improve cardiovascular outcomes in cancer survivors. Further prospective research is warranted to refine biomarker thresholds and develop personalized monitoring algorithms for timely cardioprotective interventions