Prognostic value of troponin I in cardiac risk stratification of cancer patients undergoing high-dose chemotherapy

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Abstract

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

Original languageEnglish
Pages (from-to)38-43
Number of pages6
JournalRivista Italiana della Medicina di Laboratorio
Volume1
Issue number1
Publication statusPublished - Jan 2005

Keywords

  • Cardiac toxicity
  • Chemotherapy
  • Troponin
  • Ventricles

ASJC Scopus subject areas

  • Biochemistry, medical
  • Medical Laboratory Technology

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