High-sensitivity cardiac troponin I and T methods for the early detection of myocardial injury in patients on chemotherapy

Author:

Clerico Aldo1,Cardinale Daniela Maria2,Zaninotto Martina3,Aspromonte Nadia4,Sandri Maria Teresa5,Passino Claudio1,Migliardi Marco6,Perrone Marco7,Fortunato Antonio8,Padoan Andrea3ORCID,Trenti Tommaso9,Bernardini Sergio7,Sciacovelli Laura3ORCID,Colivicchi Furio10,Gabrielli Domenico11,Plebani Mario3ORCID

Affiliation:

1. Laboratory of Cardiovascular Endocrinology and Cell Biology , Department of Laboratory Medicine, Scuola Superiore Sant’Anna e Fondazione CNR – Regione Toscana G. Monasterio , Pisa , Italy

2. Unità di Cardioncologia, Istituto Europeo di Oncologia, I.R.C.C.S. , Milan , Italy

3. Dipartimento di Medicina di Laboratorio , Azienda Ospedaliera Universitaria di Padova, and Dipartimento di Medicina – Università di Padova , Padova , Italy

4. Dipartimento Scienze Cardiovascolari e Toraciche , Fondazione Policlinico Universitario A. Gemelli IRCCS (FANMCO, FACC, Consigliere ANMCO Nazionale) , Rome , Italy

5. Unità Operativa Laboratorio Analisi, Humanitas Medical-Care , Rozzano, Milan , Italy

6. Struttura Complessa Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano , Torino , Italy

7. Dipartimento di Medicina Sperimentale , Università di Roma Tor Vergata , Rome , Italy

8. U.O.C. Patologia Clinica, ASUR Marche Area Vasta 5 , Ascoli Piceno , Italy

9. Dipartimento di Medicina di Laboratorio and Anatomia Patologica , Azienda Ospedaliera Universitaria and USL di Modena , Modena , Italy

10. U.O.C. Cardiologia, P.O. San Filippo Neri – ASL Roma 1, Rome (Società Scientifica ANMCO) , Roma , Italy

11. U.O.C. Cardiologia, Ospedale Civile Augusto Murri, Fermo (Società Scientifica ANMCO) , Fermo , Italy

Abstract

Abstract Important advances achieved in pharmacological cancer treatment have led progressively to a reduction in mortality from many forms of cancer, and increasing numbers of previously incurable patients can now hope to become cancer-free. Yet, to achieve these improved outcomes a high price has been paid in terms of untoward side effects associated with treatment, cardio-toxicity in particular. Several recent studies have reported that cardiac troponin assay using high-sensitivity methods (hs-cTn) can enable the early detection of myocardial injury related to chemotherapy or abuse of drugs that are potentially cardiotoxic. Several authors have recently suggested that changes in hs-cTn values enable the early diagnosis of cardiac injury from chemotherapy, thus potentially benefitting cancer patients with increased troponin values by initiating early cardioprotective therapy. However, large randomised clinical trials are needed in order to evaluate the cost/benefit ratio of standardised protocols for the early detection of cardiotoxicity using the hs-cTn assay in patients treated with chemotherapy.

Publisher

Walter de Gruyter GmbH

Subject

Biochemistry (medical),Clinical Biochemistry,General Medicine

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