ORIGINAL ARTICLE

Role of angiotensin-converting enzyme inhibitors on changes in troponin levels in breast cancer with anthracycline chemotherapy

Adi Rizka , Heru Purwanto, M. Bachtiar Budianto, Mohammad Saifur Rohman

Adi Rizka
Department of Oncology Surgery, Faculty of Medicine, Malikussaleh University- Cut Meutia Hospital, Lhokseumawe, Aceh, Indonesia. Email: adirizka@unimal.ac.id

Heru Purwanto
Department of Oncology Surgery, Faculty of Medicine, Airlangga University - Dr. Soetomo Hospital, Surabaya, Indonesia

M. Bachtiar Budianto
Department of Oncology Surgery, Faculty of Medicine, Brawijaya University - Dr. Saiful Anwar Hospital Malang, Indonesia

Mohammad Saifur Rohman
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Brawijaya University -Dr. Saiful Anwar Hospital Malang, Indonesia
Online First: August 11, 2021 | Cite this Article
Rizka, A., Purwanto, H., Budianto, M., Rohman, M. 2021. Role of angiotensin-converting enzyme inhibitors on changes in troponin levels in breast cancer with anthracycline chemotherapy. Bali Medical Journal 10(2): 728-732. DOI:10.15562/bmj.v10i2.2354


Introduction: Breast cancer is the most common type of cancer among women throughout the world. The anthracycline is widely used in the treatments of this cancer. Although it is very effective, its usage is limited due to side effects, such as heart failure. Angiotensin-converting enzyme inhibitors (ACEi) have been reported to delay the process of left ventricular (LV) dysfunction in several clinical trials. This study assesses the role of ACEi in the alteration of troponin levels in breast cancer patients treated in anthracycline chemotherapy.

Methods: This research was a clinical trial Quasi-experimental design that has a control group, whereas the treatment group is purposively determined. The treatment group received with anthracycline chemotherapy plus ACEi, and the ACEi were given before chemotherapy until to 3rd cycle of chemotherapy. Initial troponin levels of the patients were measured pre- and post-treatment, whereas the sample size was determined by calculating via the equation from 15 people each group.

Results: The administering of ACEi could prevent increasing troponin levels by an average of 0.1133 ng/dl from 0.120 ± 0.077 ng/dl to 0.233 ± 0.219 ng/dl, with a p-value = 0.014. Delta Troponin's in Mann-Whitney test value has a p-value of 0.021, so it can be concluded that there is a significant difference between control and treatment group in Delta Troponin, in which the value of control has fewer number than the control treatment.

Conclusion: The treatment group that received the ACEi intervention could prevent an increase of troponin levels after chemotherapy. Overall, it can be concluded that the consumption ACEi can inhibit the rise of Troponin.

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