The Effect of N-Acetylcysteine Administration to Prevent Anthracycline-Induced Cardiotoxicity in Breast Cancer Patients

Introduction: Anthracyclines are one of the classes of chemotherapy drugs that  are widely used to treat many types of cancers including breast cancer. Taking this class of medications has a significant relationship with cardiac dysfunction. N-acetylcysteine has antioxidant properties and may be effective in preventing cardiac dysfunctions. In this study, we investigated the effect of N-acetylcysteine in preventing cardiotoxicity in breast cancer patients receiving anthracycline. Methods:  A  total  of  60  breast  cancer  patients  who  underwent  chemotherapy  with anthracyclines were enrolled in the present case-control study and divided into two groups. The case group received 600 mg of N-acetylcysteine per day adjacent to chemotherapy; while  the  control  group  did  not  receive  this  medication.  One  month  after  the  last chemotherapy session, troponin I was measured as a predictor of cardiotoxicity. Results: Troponin I was positive in one patient in the case group compared with 3 patients in the control group without any significant difference among groups (P> 0.05) However, the respective mean±SD level of troponin I was 0.120±0.039 and 0.192±0.063 in the case and control groups with a statistically significant difference among groups (P <0.001). Conclusions: Administration of 600 mg N-acetylcysteine per day during the anthracycline- based chemotherapy protocol in breast cancer patients may reduce the mean troponin I levels which can be a prediction of reduced anthracyclines cardiotoxicity.