Cardiac Biomarkers and Echocardiographic Findings in Patients with Multiple Myeloma With and Without Major Adverse Cardiovascular Events

Abstract

Background: Both disease- and treatment-related factors increase the risk of cardiovascular complications in multiple myeloma (MM) patients. The purpose of this study was to find parameters that are independently linked to major adverse cardiovascular events (MACE) by evaluating cardiac involvement using echocardiography and cardiac biomarkers in both MACE-and non-MACE patients.

Methods: This comparative cross-sectional analytical research included one hundred MM patients who were getting treatment at Cardiology Department, Al-Ahrar Teaching Hospital, GOTHI. Half of the patients were assigned to the MACE group and half to the non-MACE group. Clinical assessment, laboratory testing, and transthoracic echocardiography were all part of the protocol for all subjects. We used multivariate logistic regression and (ROC) curve analysis to find characteristics that were linked with MACE separately.

Results: In addition to being considerably older, patients with MACE exhibited lower hemoglobin and albumin levels, more frequent cardiovascular symptoms, decreased renal function, and higher levels of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). The echocardiography results showed that the MACE group had larger cardiac chambers, a lower LVEF, and more severe diastolic dysfunction. The E/e′ ratio, age, creatinine, hs-cTnT, NT-proBNP, LVEF, and NT-proBNP were all separately linked to MACE. When it came to identifying individuals with MACE, NT-proBNP had the best diagnostic performance (AUC = 0.99), although high-sensitivity cardiac troponin (hs-cTnT) and E/e′ ratio were close behind (AUC = 0.88 and 0.79, respectively).

Conclusion: In MM patients with MACE, cardiac structural and functional abnormalities were more noticeable. An efficient method for stratifying cardiovascular risk is the combination of echocardiography with evaluation of cardiac biomarkers. Patients with MM may benefit from improved cardiovascular risk assessment and easier identification of those with more severe cardiac involvement if these non-invasive methods are routinely used together.