Test Predicts Heart Damage from Chemotherapy

Various chemotherapy drugs used for cancer can damage the heart–now researchers have identified a test that can predict if heart problems are likely to occur.

Various chemotherapy drugs used for cancer can damage the heart–now researchers have identified a test that can predict if heart problems are likely to occur. After chemotherapy, increased blood levels of a protein called troponin I indicate a high risk of heart problems in the next few years, according to a report in Circulation: Journal of the American Heart Association. “Our study is the first to clearly show, in an adult population, that the risk of cardiac events in cancer patients can be predicted by evaluating (troponin I levels after) chemotherapy,” lead author Dr. Daniela Cardinale, from the European Institute of Oncology in Milan, Italy, said in a statement. Previous reports have linked troponin I elevations with heart pumping problems in patients treated with a variety of high-dose chemotherapy regimens. However, the time course of heart damage and the effect on patient outcomes has not been studied. To investigate, the researchers measured troponin I levels soon after chemotherapy (early) and one month later (late) in 703 cancer patients. Overall, 495 patients had no troponin I elevations, 145 had an early elevation only, and 63 had early and late elevations, the authors report. During an average follow-up period of 20 months, the group without troponin I elevations experienced no drop in heart pumping ability. In the other groups, by contrast, a substantial number of patients experienced major reductions. The troponin I elevation was strongly predictive of heart problems. Going from no elevations at either time point to elevations at both, the rate of such problems increased from 1 to 17 to 84 percent, respectively. Doctors can use troponin I testing to identify patients at high risk for heart problems and possibly intervene to reduce their risk, Cardinale said. (SOURCE: Circulation: Reuters Health News: May 2004.)