{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:08:43Z","timestamp":1788872923963,"version":"build-2803163510"},"reference-count":16,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Cardiotoxicity remains a major limitation in breast cancer treatment, especially with anthracyclines and radiotherapy. Early biomarkers may improve risk stratification.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This retrospective cohort study included breast cancer patients treated between 2020 and 2023 with chemotherapy and\/or radiotherapy. Troponin I (TPI) and N-terminal pro B-type natriuretic peptide (NT-proBNP) were measured at baseline and at three, six, 12, 18, 24, 30, and 36 months. Cardiotoxicity was defined per European Society of Cardiology (ESC) guidelines as a \u226510% drop in left ventricular ejection fraction (LVEF) to &lt;53% or &gt;15% relative reduction in global longitudinal strain (GLS). Receiver operating characteristic (ROC) analysis, logistic regression, and mixed-effects models assessed associations.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 190 patients were included; 141 patients (74.2%) developed cardiotoxicity within 12 months. At six months, NT-proBNP (median: 212.6 pg\/mL) and TPI (0.038 ng\/mL) were significantly higher in the cardiotoxic group (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.01). ROC area under the curve (AUC) for NT-proBNP at six months was 0.83 (95% CI: 0.77\u20130.89); for TPI, AUC = 0.79 (95% CI: 0.73\u20130.86). Multivariable regression showed both biomarkers remained independent predictors of cardiotoxicity after adjustment for GLS and cumulative anthracycline dose (NT-proBNP: OR 1.78 [95% CI 1.22\u20132.61],\n                    <jats:italic>p<\/jats:italic>\n                    = 0.003).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In this real-world breast cancer cohort, serial NT-proBNP and TPI monitoring, particularly at 3 and 6 months, provided meaningful early prognostic information for subsequent cardiotoxicity beyond baseline assessment alone. When integrated with echocardiographic surveillance, these biomarkers may support earlier identification of high-risk patients, more tailored cardio-oncology follow-up, and timely cardioprotective intervention, although prospective external validation is required before routine implementation.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2026.60","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:31:25Z","timestamp":1788870685000},"source":"Crossref","is-referenced-by-count":0,"title":["Added value of serial troponin I and N-terminal pro B-type natriuretic peptide for early detection of cardiotoxicity in breast cancer: A three-year retrospective cohort study"],"prefix":"10.5339","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9250-1454","authenticated-orcid":true,"given":"Benard","family":"Shehu","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital Center \"Mother Teresa,\" Tirana, Albania"},{"name":"Department of Biomedical and Experimental Sciences, Faculty of Medical Sciences, University of Medicine, Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2031-5524","authenticated-orcid":true,"given":"Klerida","family":"Shehu","sequence":"additional","affiliation":[{"name":"Department of Paraclinical Sciences, Faculty of Medical Sciences, University of Medicine, Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7685-8394","authenticated-orcid":true,"given":"Bledar","family":"Kraja","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Experimental Sciences, Faculty of Medical Sciences, University of Medicine, Tirana, 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