Scholarlink

Background <p>The quest for new, reliable prognostic markers of cardiovascular toxicity in patients undergoing anthracycline therapy remains a crucial challenge. The serum hemoglobin-to-creatinine ratio (Hb/Cr) has never been investigated in this setting. We explored the association between the Hb/Cr ratio and early surrogate markers of anthracycline-related cardiotoxicity in patients with hematological disorders.</p> Methods <p>Among 171 patients included in a retrospective registry, 7 were excluded due to missing data. Patients underwent echocardiographic evaluation before and after at least one cycle of anthracycline-based chemotherapy, over a median follow-up of 135 days. The primary endpoint was post-chemotherapy cardiac dysfunction (PCCD), defined as a composite of reduced left ventricular ejection fraction, new-onset diastolic dysfunction, or increased left ventricular end-diastolic diameter.</p> Results <p>Patients were stratified into low versus high Hb/Cr groups. After at least one chemotherapy cycle, PCCD occurred more frequently in patients with lower Hb/Cr values (57.5% vs. 40.7%, <i>p</i> = 0.032). In bivariate analysis, a higher Hb/Cr ratio was inversely associated with PCCD (OR 0.50; 95% CI 0.27–0.94; <i>p</i> = 0.032), mainly driven by new-onset diastolic dysfunction. This association remained significant after multivariable adjustment for age, sex, cardiovascular risk factors, and type of hematological disorder (all <i>p</i> &lt; 0.05). The Hb/Cr ratio demonstrated superior discriminative performance for PCCD (AUC 0.59) compared with hemoglobin (AUC 0.50) and creatinine (AUC 0.45) considered separately (both <i>p</i> &lt; 0.05).</p> Conclusions <p>Lower baseline Hb/Cr values are independently associated with early surrogate markers of anthracycline-related cardiotoxicity. Larger prospective studies are warranted to validate its prognostic value.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Serum hemoglobin-to-creatinine ratio is associated with early surrogate markers of anthracycline-related cardiotoxicity: a retrospective analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月23日

查看全文
  • Luigi Spadafora,
  • Marco Bernardi,
  • Gianmarco Sarto,
  • Beatrice Simeone,
  • Erica Rocco,
  • Valentina Valenti,
  • Rachele Di Mario,
  • Gianmarco Rossi,
  • Filippo Zanasi,
  • Maurizio Forte,
  • Giacomo Frati,
  • Francesco Versaci,
  • Luigi Frati,
  • Attilio Lauretti,
  • Michela Cece,
  • Sara Vitale,
  • Giuseppe Cimino,
  • Azzurra Romeo,
  • Alessandro Pulsoni,
  • Mariangela Peruzzi,
  • Giuseppe Biondi-Zoccai,
  • Sebastiano Sciarretta

摘要

Background

The quest for new, reliable prognostic markers of cardiovascular toxicity in patients undergoing anthracycline therapy remains a crucial challenge. The serum hemoglobin-to-creatinine ratio (Hb/Cr) has never been investigated in this setting. We explored the association between the Hb/Cr ratio and early surrogate markers of anthracycline-related cardiotoxicity in patients with hematological disorders.

Methods

Among 171 patients included in a retrospective registry, 7 were excluded due to missing data. Patients underwent echocardiographic evaluation before and after at least one cycle of anthracycline-based chemotherapy, over a median follow-up of 135 days. The primary endpoint was post-chemotherapy cardiac dysfunction (PCCD), defined as a composite of reduced left ventricular ejection fraction, new-onset diastolic dysfunction, or increased left ventricular end-diastolic diameter.

Results

Patients were stratified into low versus high Hb/Cr groups. After at least one chemotherapy cycle, PCCD occurred more frequently in patients with lower Hb/Cr values (57.5% vs. 40.7%, p = 0.032). In bivariate analysis, a higher Hb/Cr ratio was inversely associated with PCCD (OR 0.50; 95% CI 0.27–0.94; p = 0.032), mainly driven by new-onset diastolic dysfunction. This association remained significant after multivariable adjustment for age, sex, cardiovascular risk factors, and type of hematological disorder (all p < 0.05). The Hb/Cr ratio demonstrated superior discriminative performance for PCCD (AUC 0.59) compared with hemoglobin (AUC 0.50) and creatinine (AUC 0.45) considered separately (both p < 0.05).

Conclusions

Lower baseline Hb/Cr values are independently associated with early surrogate markers of anthracycline-related cardiotoxicity. Larger prospective studies are warranted to validate its prognostic value.