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- W3113881520 abstract "Abstract Aims Immune checkpoint inhibitors (ICIs) are an emerging option for several advanced metastatic cancers, but have been associated with cardiotoxicity. The prognostic value of high-sensitivity troponin T (hs-TnT) measured before treatment start has never been investigated. Methods and results Thirty consecutive patients underwent measurement of hs-TnT before starting ICI therapy (pembrolizumab, 23%; nivolumab, 12%; atezolizumab, 6%; durvalumab, 5%). The primary endpoint was a composite of cardiovascular death, stroke or transient ischaemic attack, pulmonary embolism and new-onset heart failure. The secondary endpoint was progression of cardiac involvement according to the CARDIOTOX staging system. Patients (median age 68 years, 77% men, 13% with coronary artery disease, 90% current or former smokers, 67% overweight or obese, and 43% hypertensive) had a median hs-TnT of 12 ng/L (interquartile interval 8-23). At the 3-month timepoint, 7 patients (23%) had experienced the primary endpoint, and 13 (43%) the secondary endpoint. Area under the curve values were 0.909 for the primary, and 0.757 for the secondary endpoint. The best troponin-T cut-off was 14 ng/L for both the primary (100% sensitivity, 73% specificity) and secondary endpoint (sensitivity 75%, specificity 77%). Over a median follow-up duration of 2.6 months (2.0-3.6), survival free from the primary endpoint was shorter in patients with hs-TnT ≥14 ng/L (Log-rank: 10.3, p = 0.001), and all patients developing the primary endpoint had hs-TnT ≥14 ng/L at baseline. Conclusion In patients on ICIs, baseline hs-TnT predicts a composite cardiovascular endpoint and the progression of cardiac involvement at 3 months, with 14 ng/L as the best cut-off." @default.
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- W3113881520 date "2020-12-01" @default.
- W3113881520 modified "2023-09-23" @default.
- W3113881520 title "76 Pre-treatment high-sensitivity troponin T for the short-term prediction of cardiac outcomes in patients on immune checkpoint inhibitors" @default.
- W3113881520 doi "https://doi.org/10.1093/eurheartj/suaa193" @default.
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