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First, a PRISMA-compliant (ID: CRD42023453369) meta-analysis of 12 studies (11 prospective cohorts, 1 RCT; 917 patients; age 50.4 \u00b1 16.0 years; median follow-up 12 months) from five databases (PubMed\/Web of Science\/Embase\/Cochrane\/ClinicalTrials.gov) quantified post-treatment biomarker changes using weighted\/standardized mean differences (WMD\/SMD) and CTRCD risk via hazard ratios (HRs). Second, two-sample MR analysis leveraged MPO-associated single nucleotide polymorphisms (SNPs) to assess causality with heart failure (HF) and cardiomyopathy, employing IVW, MR-Egger, weighted median and simple mode methods with heterogeneity testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The meta-analysis demonstrated significant post-treatment elevations in: MPO [US patients: SMD = 0.78, 95% confidence interval (CI) 0.45\u20131.12; I2 = 72%; P &amp;lt; 0.00001], GDF-15 (SMD = 0.64, 95% CI 0.24\u20131.05; I2 = 77%; P = 0.002), PLGF (SMD = 0.87, 95% CI 0.10\u20131.63; I2 = 95%; P = 0.03), and CRP (WMD = 0.83, 95% CI 0.46\u20131.20; I2 = 18%; P &amp;lt; 0.0001). Subgroup analyses eliminated heterogeneity for GDF-15 (I2 = 0%) and PLGF (I2 = 0%), while partially reducing heterogeneity for MPO (I2 = 72%). Elevated MPO levels predicted increased CTRCD risk in patients receiving cancer treatment (HR = 1.30, 1.10\u20131.54; I2 = 0%; P = 0.002). MR analysis suggested causal relationships between MPO and both HF [odds ratio (OR) = 1.06, 95% CI 1.02\u20131.09; P = 0.001] and cardiomyopathy (OR = 1.09, 95% CI 1.02\u20131.17; P = 0.02), with significant heterogeneity detected in heart failure SNPs (Cochran's Q = 61.63, P = 0.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study suggested that MPO was associated with both diagnostic biomarker profiles and mechanistic pathways in CTRCD pathogenesis. These preliminary findings highlighted MPO as a possible target for further investigation of early CTRCD detection in breast cancer patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15363","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T08:19:36Z","timestamp":1758097176000},"page":"4194-4207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Early Diagnostic Value of Novel Biomarkers for Breast Cancer Therapy-Related Cardiac Dysfunction"],"prefix":"10.1093","volume":"12","author":[{"given":"Zhengwei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Cardiovascular Research Center, The First Affiliated Hospital of Chongqing Medical University , Chongqing 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,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Cardiovascular Research Center, The First Affiliated Hospital of Chongqing Medical University , Chongqing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"2026021804191180700_ehf215363-bib-0001","doi-asserted-by":"publisher","first-page":"51","DOI":"10.2147\/CE.S217848","article-title":"Pertuzumab in the treatment of HER2-positive breast cancer: an evidence-based review of its safety, efficacy, and place in therapy","volume":"14","author":"Ishii","year":"2019","journal-title":"Core Evid"},{"key":"2026021804191180700_ehf215363-bib-0002","doi-asserted-by":"publisher","DOI":"10.3390\/genes13060960","article-title":"The history of early breast cancer 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