title: Minor increases in plasma troponin I predict decreased left ventricular ejection fraction after high-dose chemotherapy.
abstract: BACKGROUND
  Increased cardiac troponin I (cTnI) in patients treated with high-dose chemotherapy (HDCT) for aggressive malignancy has been proposed as an early marker of late HDCT-induced cardiac dysfunction. We investigated whether cTnI measured by the Stratus CS (Dade Behring) would allow detection of minimal cTnI increases in patients treated with HDCT.
  
  
  METHODS
  Plasma cTnI concentrations were determined in 179 consecutive patients before HDCT, at the end of the treatment, and after 12, 24, 36, and 72 h. Cardiac function was explored by echocardiography, and left ventricular ejection fraction (LVEF) was recorded during follow-up. The greatest variation in LVEF from the baseline value was used as a measure of cardiac damage.
  
  
  RESULTS
  In 99 healthy volunteers, the 99th percentile was at 0.07 microg/L. On the basis of ROC curve analysis (area under the curve, 0.89), a cutoff of 0.08 microg/L was chosen (sensitivity, 82%; specificity, 77%). cTnI > or =0.08 microg/L occurred in 57 patients (32%) with echocardiographic monitoring revealing a mean decrease in LVEF of 18%. In comparison, the group of cTnI-negative patients had a mean decrease in LVEF of 2.5% (P <0.001).
  
  
  CONCLUSIONS
  Plasma cTnI, as measured with the Stratus CS, can detect minor myocardial injury in patients treated with HDCT.
authors.affiliation: Division of Pathology, Laboratory Medicine Unit, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy. maris.sandri@ieo.it
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Sandri
authors.forename: Daniela
authors.initials: D
authors.lastname: Cardinale
authors.forename: Laura
authors.initials: L
authors.lastname: Zorzino
authors.forename: Rita
authors.initials: R
authors.lastname: Passerini
authors.forename: Paola
authors.initials: P
authors.lastname: Lentati
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martinoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinelli
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Cipolla
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects*; D019210:Troponin I / Q000097:blood*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D000970:Antineoplastic Agents; D019210:Troponin I