Clinical value of high sensitive cardiac troponin Ⅰ in monitoring cardiac toxicity in patients treated with anthracycline / 心血管康复医学杂志

ABSTRACT

Objective:To explore value of high sensitive cardiac troponin I (hs-cTnI) in monitoring cardiac toxicity of patients with leukemia undergoing anthracycline chemotherapy .Methods:A total of 160 patients with acute myeloid leukemia ,who were treated in our department from Jan 2013 to Dec 2016 ,were enrolled .Patients were randomly divided into routine chemotherapy group and Dexrazoxane group (received Dexrazoxane on 30 min before chemo-therapy) ,both groups were treated for six periods (21d×6).Serum hs-cTnI level and incidence of cardiac toxicity events before and at different time points after chemotherapy were observed and compared between two groups .In-cidence rate of cardiac toxicity events was compared between groups with different serum hs-cTnI level.ROC curve was used to analyze predictive value of serum hs-cTnI for cardiac toxicity .Results:Compared with before chemo-therapy ,after chemotherapy ,there was significant rise in serum hs-cTnI level in each period in two groups ( P＝0.001 all) ,and it rose along with time passed .Compared with routine chemotherapy group from second period , there was significant reduction in serum hs-cTnI level [2nd21d(7.59 ± 0.85) 10－2ng/ml vs.(7.27 ± 0.86) 10－2ng/ml ,] in Dexrazoxane group , P＜ 0.05 or ＜ 0.01. Total incidence rate of cardiac toxicity events of Dexrazoxane group was significantly lower than that of routine chemotherapy group (5.00% vs.25.00%) ,P＝0.001. Incidence rate of cardiac toxicity event in hs-cTnI＞0.100ng/ml group was significantly higher than that of hs-cTnI≤0.100ng/ml group (31.25% vs.4.17%) ,P＝0.001. ROC curve suggested that AUC was 0.825 ,cutoff point was 0.121 ng/ml ,sensitivity and specificity was 90.27% and 92. 35% respectively for serum hs-cTnI predicting cardiac toxicity in these patients .Conclusion: Serum hs-cTnI level rises in early period of chemotherapy in patients with leukemia un- dergoing anthracycline chemotherapy , so it possesses high predictive value for cardiac toxicity events .