Poster Presenter

Plasma Natriuretic Peptides In Carcinoma Patients
Ljerka Lukinac, Drazena Krilic, Ana Frobe, Zeljko Soldic, Zvonko Kusic
Croatia

Plasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) as well as their precursors are recognized to be valuable heart markers. Patients with cancer are often treated with potentially cardiotoxic chemotherapeutics. Available data suggest that the levels of circulating cardiomarkers can indicate the extent and severity of the myocardial damage during chemotherapy. Those markers may serve as the prognostic indicators for long term survival.

Objective: The purpose of the study was to measure possible changes of plasma BNP and ANP after receiving more then one cycle of chemotherapy.

Patients and methods: Study introduced 83 patients with breast and gastrointestinal cancers treated with anthracycline-based chemotherapy. Patients received between one and six cycles of chemotherapy.

Fasting blood samples are collected for BNP into EDTA (Na) plastic tubes and for ANP to chilled tubes containing EDTA and aprotinin. Aliquots are stored at -22°C. Concentrations of both hormones were determined by an immunoradiometric assay (Shionoria BNP/ Shionoria ANP, CIS Bio International). The cut-off value for BNP and ANP were 18. 4 pg/mL and 43 pg/mL.

Results: Plasma levels of BNP and ANP were determined in total of 96 samples related to 83 patients. In 70 patients BNP and ANP were determined only once and for 13 patients twice. In a total of 96 determinations, BNP was increased in 44 (52 %) and ANP only in 22 (24 %). Group one consisted of 31 patients who received 1-2 cycles, group two of 72 patients who received 3-4 cycles and group three of 34 patients who received 5-6 cycles of chemotherapy.

In group one BNP was increased in 54% and ANP in 20%, in group two BNP was increased in 50% and ANP in 22% and in group three increased BNP and ANP were found in 54% and 31% of samples. Of 13 patients with two blood samples, 10 patients had BNP/ANP values less then cut-off value and only one patient had both markers increased. In one patient BNP alone was increased after therapy (5 to 6 cycle) and in other patient only ANP normalized after therapy (2 to 6 cycle). In one patient BNP remained increased after 5 cycles of therapy.

Conclusions: Results confirmed that in plasma of oncological patients BNP levels increased twice as much as ANP values.

There was no correlation between the increased levels of BNP and the number of cycles of chemotherapy. A slightly higher proportion of increased ANP was detected in patients with received 5-6 cycles of chemotherapy.

In majority of patients with two plasma samples the levels of BNP and ANP were not increased after