Annals of Oncology 13:710-715, 2002
© 2002 European Society for Medical Oncology
Original Paper |
Myocardial injury revealed by plasma troponin I in breast cancer treated with high-dose chemotherapy
1Cardiology Unit, 2Pathology and Laboratory Medicine and 3Clinical Haemato-Oncology Divisions, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
Received 14 September 2001; revised 28 November 2001; accepted 19 December 2001.
Background
High-dose chemotherapy (HDC) has been widely utilized in high-risk breast cancer, but it may induce cardiac toxicity. Cardiac dysfunction may become evident weeks or months after HDC and, to date, no early markers of myocardial injury that are able to predict late ventricular impairment are available. We investigated the role of plasma troponin I (TnI) in this setting.
Patients and methods
We measured TnI plasma concentration after HDC in 211 high-risk breast cancer women (46 ± 11 years, mean ± SD). According to TnI value (<0.5 or 
0.5 ng/ml), patients were allocated into a troponin positive (TnI+; n = 70) and a troponin negative (TnI–; n = 141) group. All patients underwent left ventricular ejection fraction (LVEF, Echo) examination during the following 12 months.
Results
LVEF progressively decreased in the TnI+ group but not in the TnI– group. In TnI+ patients a close relationship between the TnI increase, as well as the number of positive TnI assays, and the maximal LVEF decrement, was found (r = –0.92, P <0.0001 and r = –0.93, P <0.0001, respectively).
Conclusions
In our population, the elevation of TnI soon after HDC accurately predicts the development of future LVEF depression. In this setting, TnI can be considered a sensitive and reliable marker of myocardial damage with relevant clinical and prognostic implications.
Key words: breast cancer, cardiotoxicity, high-dose chemotherapy, troponin I
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