Background:
Anthracyclines, such as doxorubicin, are effective chemotherapies but cause dose-dependent cardiotoxicity, leading to heart failure (HF) and impaired recovery. Lipoprotein(a) [Lp(a)] is a pro-inflammatory and pro-oxidative biomarker that may exacerbate anthracycline-induced cardiac injury and hinder recovery, yet its role remains unexplored.
Objective:
To evaluate the association between elevated Lp(a) levels, anthracycline-induced cardiotoxicity, and cardiac recovery.
Specific Aims:
Aim 1: Assess the association between elevated Lp(a) levels and cardiotoxicity in anthracycline-treated patients (defined by new/worsening HF [ICD-10 I50] or LVEF decline).
Aim 2: Determine whether elevated Lp(a) impairs cardiac recovery (LVEF improvement !50% within 6-12 months).
Approach:
Use UK Biobank data to identify anthracycline-treated patients with Lp(a) measurements.
Perform multivariable regression and time-to-event analyses, adjusting for confounders (age, sex, dose, baseline risk factors).
Impact:
This study will establish Lp(a) as a novel biomarker for cardiotoxicity risk and recovery, enabling personalized risk stratification and improved cardiac outcomes in anthracycline-treated cancer patients.