Salim Hayek, Professor and Chair of Internal Medicine at UTMB and Cardiologist, shared on LinkedIn:
“Does checkpoint inhibitor therapy raise troponin on its own in patients who never develop myocarditis? And is there a difference between troponin I and troponin T?
New in JACC: CardioOncology from our team.
We measured troponin T and troponin I on the same blood samples from 433 patients at the University of Michigan, starting before their first dose. More than a third already had a high troponin T with a normal troponin I.
One month into treatment, that proportion was essentially unchanged, and neither troponin had risen.
We use troponin to monitor for myocarditis, an immune-mediated attack on the heart muscle that can occur during checkpoint inhibitor therapy. A positive result can lead to stopping cancer treatment and starting high-dose steroids.
European guidelines recommend checking troponin before and during treatment, but major guidelines do not specify which troponin assay should be used.Patients with a high troponin T and normal troponin I were older, more often men, and more likely to have kidney disease.
That pattern may reflect troponin T coming from non-cardiac muscle and remaining in circulation longer when kidney clearance is reduced.
Troponin I, in contrast, is specific to cardiac muscle.
Anis Ismail led the study, published this month in JACC: CardioOncology.
If both tests are checked before the first dose, any later rise has a clearer baseline for comparison.
Guidelines tell us to check troponin. They should also say which one.”
Other articles about Cardio-Oncology on OncoDaily.