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Italian EDITORIALI - Editorials
Volume:
Biochimica Clinica 2020; 44(3) 279-286
Pubblicato on-line:
July 9, 2020
DOI:
10.19186/BC_2020.062
Valutazione precoce del danno cardiaco da farmaci chemioterapici: importanza della misura delle troponine cardiache I e T con metodi ad alta-sensibilità analitica
High-sensitivity cardiac troponin I and T methods for the early detection of myocardial injury in patients on chemotherapy
AUTORI
Mario Plebani3, Marco Migliardi6, Marco Perrone7, Antonio Fortunato8, Andrea Padoan3, Tommaso Trenti9, Sergio Bernardini7,
Laura Sciacovelli3, Furio Colivicchi10, Domenico Gabrielli11
1Scuola Superiore Sant’Anna e Fondazione CNR – Regione Toscana G. Monasterio, Pisa
2Unità di Cardioncologia, Istituto Europeo di Oncologia, I.R.C.C:S., Milano
3Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera Universitaria di Padova, e Dipartimento di Medicina - Universitàdi Padova
4Dipartimento Scienze Cardiovascolari, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Roma
5Unità Operativa Laboratorio Analisi, Humanitas Medical-Care, Rozzano (Milano)
6Struttura Complessa Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano, Torino
7Dipartimento di Medicina Sperimentale, Università di Roma Tor Vergata, Roma
8U.O.C. Patologia Clinica, ASUR Marche Area Vasta 5, Ascoli Piceno
9Dipartimento di Medicina di Laboratorio e Anatomia Patologica, Azienda Ospedaliera Universitaria e Unità Sanitaria Locale di Modena, Modena
10Unità OperativaComplessa di Cardiologia, Presidio Ospedaliero San Filippo Neri - ASL Roma 1, Roma
11Unità Operativa Complessa di Cardiologia, Ospedale Civile Augusto Murri, Fermo
ABSTRACT
High-sensitivity cardiac troponin I and T methods for the early detection of myocardial injury in patients on chemotherapy
Important advances achieved in pharmacological cancer treatment have led progressively to a reduction in mortality from many forms of cancer, and increasing numbers of previously incurable patients can now hope to become cancer-free. Yet, to achieve these improved outcomes a high price has been paid in terms of untoward side effects associated with treatment, cardiotoxicity in particular. Several recent studies have reported that cardiac troponin assay using high-sensitivity methods (hs-cTn) can enable the early detection of myocardial injury related to chemotherapy or abuse of drugs that are potentially cardiotoxic. Several authors have recently suggested that changes in hs-cTn values enable the early diagnosis of cardiac injury from chemotherapy, thus potentially benefitting cancer patients with increased troponin values by initiating early cardioprotective therapy. However, large randomised clinical trials are needed in order to evaluate the cost/benefit ratio of standardised protocols for the early detection of cardiotoxicity using the hs-cTn assay in patients treated with chemotherapy.