{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:36:26Z","timestamp":1790724986306,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T00:00:00Z","timestamp":1601164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Immune checkpoint inhibitors (ICIs) are an emerging option for several advanced metastatic cancers, but may have cardiotoxic effects. The prognostic value of high\u2010sensitivity troponin T (hs\u2010TnT) before treatment start has never been investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Thirty consecutive patients underwent measurement of hs\u2010TnT before starting ICI therapy (pembrolizumab, 23%; nivolumab, 12%; atezolizumab, 6%; durvalumab, 5%). The primary endpoint of cardiovascular death, stroke or transient ischaemic attack, pulmonary embolism and new\u2010onset heart failure, and the secondary endpoint of progression of cardiac involvement according to the CARDIOTOX classification were evaluated after 3\u00a0months from the first cycle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients (median age 68\u00a0years, 77% men, 13% with coronary artery disease, 90% current or former smokers, 67% overweight or obese and 43% hypertensive) had a median hs\u2010TnT of 12\u00a0ng\/L (interquartile interval 8\u201023). The primary endpoint occurred only in patients with hs\u2010TnT\u00a0\u2265\u00a014\u00a0ng\/L at baseline. Therefore, only patients who had hs\u2010TnT\u00a0\u2265\u00a014\u00a0ng\/L before the first cycle died had a stroke\/TIA or new\u2010onset HF. Furthermore, nine out of 13 patients with the secondary endpoint (progression of cardiac disease) had hs\u2010TnT\u00a0\u2265\u00a014\u00a0ng\/L before the first cycle (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.012). AUC values were 0.909 for the primary endpoint and 0.757 for the secondary endpoint. The best cut\u2010off was 14\u00a0ng\/L for both the primary (100% sensitivity, 73% specificity) and secondary endpoints (sensitivity 75%, specificity 77%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients on ICIs, baseline hs\u2010TnT predicts a composite cardiovascular endpoint and the progression of cardiac involvement at 3\u00a0months, with 14\u00a0ng\/L as the best cut\u2010off.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13400","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T07:51:04Z","timestamp":1600242664000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Pre\u2010treatment high\u2010sensitivity troponin T for the short\u2010term prediction of cardiac outcomes in patients on immune checkpoint 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