Early Diagnostic Value of High-Sensitivity Cardiac Troponin T for Cancer Treatment-Related Cardiac Dysfunction: A Meta-Analysis

作者：Xinfang Lv, Chen-liang Pan, Huan Guo, Juan Chang, Xiang Gao, Xue Wu, Xiaodong Zhi, Chunzhen Ren, Qilin Chen, Hugang Jiang, Xinke Zhao, Kai Liu, Yingdong Li · 发表于：ESC Heart Failure · 年份：2023 · DOI：10.1002/ehf2.14373 · 被引用次数：25 · 研究领域：Chemotherapy-induced cardiotoxicity and mitigation、Acute Myocardial Infarction Research、Cardiac Imaging and Diagnostics

Early diagnosis of cancer treatment-related cardiac dysfunction (CTRCD) is important as cancer therapy increases the risk of cardiac dysfunction. High-sensitivity cardiac troponin T (hs-cTnT) is a highly specific marker of myocardial injury. However, its diagnostic value for CTRCD has not been systematically evaluated. This meta-analysis aimed to evaluate whether hs-cTnT could be used as an early diagnostic biomarker for CTRCD. We systematically surveyed PubMed, Embase, Cochrane Library, and Web of Science databases for studies of hs-cTnT for the diagnosis of CTRCD before 1 April 2022. Patients of all ages and all cancer types who underwent echocardiographic left ventricular ejection fraction assessment and blood hs-cTnT and received anticancer therapy (including chemotherapy, radiotherapy, targeted therapy, immune checkpoint inhibitors, and other treatments) were included in this study, resulting in a total of eight studies with 1294 patients. The occurrence of CTRCD was associated with elevated hs-cTnT [sensitivity: 0.78, 95% confidence interval (CI): 0.64-0.88; specificity: 0.75, 95% CI: 0.59-0.86; area under the curve (AUC): 0.83, 95% CI: 0.80-0.86]. We further performed subgroup analysis and found that the AUC of hs-cTnT elevation for the diagnosis of CTRCD increased from 0.83 to 0.90 (95% CI: 0.87-0.92) at 3-6 months, suggesting a higher early diagnostic value of hs-cTnT compared with echocardiography for CTRCD. In terms of clinical applicability, the Fagan plot showed ...