TY - JOUR
T1 - Prognostic value of troponin I in cardiac risk stratification of cancer patients undergoing high-dose chemotherapy
AU - Cardinale, Daniela
AU - Sandri, Maria T.
AU - Colombo, Alessandro
AU - Colombo, Nicola
AU - Boeri, Marina
AU - Lamantia, Giuseppina
AU - Civelli, Maurizio
AU - Peccatori, Fedro
AU - Martinelli, Giovanni
AU - Fiorentini, Cesare
AU - Cipolla, Carlo M.
PY - 2004/6/8
Y1 - 2004/6/8
N2 - Background - In patients with aggressive malignancies who are undergoing high-dose chemotherapy, even minimal elevation of troponin I (TnI) is associated with late left ventricular dysfunction. The time course of the subclinical myocardial damage and its impact on the clinical outcome have never been investigated previously. Methods and Results - In 703 cancer patients, we measured TnI soon after chemotherapy (early TnI) and 1 month later (late TnI). Troponin was considered positive for values ≥0.08 ng/mL. Clinical and left ventricular ejection fraction evaluation (echocardiography) were performed before chemotherapy, 1, 3, 6, and 12 months after the end of the treatment, and again every 6 months afterward. Three different TnI patterns were identified, and patients were grouped accordingly. In 495 patients, both early and late TnI values were -/- group); in 145, there was only an early increase (TnI+/- group); and in 63 patients, both values increased (TnI+/+ group). In the TnI-/- group, no significant reduction in ejection fraction was observed during the follow-up, and there was a very low incidence of cardiac events (1%). In contrast, a greater incidence of cardiac events occurred in TnI-positive patients, particularly in the TnI+/ + group (84% versus 37% in the TnI+/- group; P
AB - Background - In patients with aggressive malignancies who are undergoing high-dose chemotherapy, even minimal elevation of troponin I (TnI) is associated with late left ventricular dysfunction. The time course of the subclinical myocardial damage and its impact on the clinical outcome have never been investigated previously. Methods and Results - In 703 cancer patients, we measured TnI soon after chemotherapy (early TnI) and 1 month later (late TnI). Troponin was considered positive for values ≥0.08 ng/mL. Clinical and left ventricular ejection fraction evaluation (echocardiography) were performed before chemotherapy, 1, 3, 6, and 12 months after the end of the treatment, and again every 6 months afterward. Three different TnI patterns were identified, and patients were grouped accordingly. In 495 patients, both early and late TnI values were -/- group); in 145, there was only an early increase (TnI+/- group); and in 63 patients, both values increased (TnI+/+ group). In the TnI-/- group, no significant reduction in ejection fraction was observed during the follow-up, and there was a very low incidence of cardiac events (1%). In contrast, a greater incidence of cardiac events occurred in TnI-positive patients, particularly in the TnI+/ + group (84% versus 37% in the TnI+/- group; P
KW - Cardiac toxicity
KW - Chemotherapy
KW - Troponin
KW - Ventricles
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U2 - 10.1161/01.CIR.0000130926.51766.CC
DO - 10.1161/01.CIR.0000130926.51766.CC
M3 - Article
C2 - 15148277
AN - SCOPUS:2942522528
VL - 109
SP - 2749
EP - 2754
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 22
ER -