Cardio-oncology & otherCohort study
Cardiac Troponin Screening and Clinical Outcomes in Patients Receiving Immunotherapy
- Retrospective cohort study
- single-centre
Authors' conclusion
cTnI surveillance integrated with symptom-based triaging can facilitate early intervention and treatment of cardiotoxicities such as myocarditis.
Study context
- Population
- Adults receiving immune checkpoint inhibitors with routine serial cardiac troponin I (cTnI) monitoring, January 2019 to October 202142 (9.8%) with elevated cTnI
- Participants
- 428 adults
- Exposure
- Symptomatic vs asymptomatic patients with elevated cTnI on surveillance
Main finding
As reported in the abstract
MACE (arrhythmia, myocarditis, HF, ACS, stroke, pericardial effusion) after cTnI elevation · 1.5 years following cTnI elevation
Subdistribution hazard ratio
18.9
95% CI 2.2–162.5
P = 0.008
Symptomatic vs Asymptomatic
subdistribution HR 18.9 (95% CI 2.2–162.5); P = 0.008
- Cumulative incidence of MACE (all with elevated cTnI)
- 19.0% (95% CI: 7.0%-31.1%)
Observational data: associations, not effects.
Further findings
Management after cTnI elevation
Outpatient evaluation
Continued immunotherapy
CMR
Immunosuppression
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality · 2-year follow-up | 3.24 (1.06–9.94) | P = 0.04 | |
| 0.10.31310Hazard ratio (log scale) |
- Management after cTnI elevation: Outpatient evaluation P < 0.001
- Management after cTnI elevation: Continued immunotherapy P < 0.001
- Management after cTnI elevation: CMR P = 0.001
- Management after cTnI elevation: Immunosuppression P = 0.008
Elevated cTnI detected through monitoring
- Elevated cTnI
- 42 (9.8%)
Myocarditis and cardiac-related deaths
- Myocarditis diagnosed
- 6
- Cardiac-related deaths
- 0
Original publication
Cardiac Troponin Screening and Clinical Outcomes in Patients Receiving Immunotherapy. JACC CardioOncol. Published 14 August 2025. doi:10.1016/j.jaccao.2025.06.009
Summarised from the published abstract; every number is checked against it