The report also suggests that tracking TNI levels can help doctors form a heart disease prevention plan for some chemotherapy patients. "Damage to the heart is one of the most worrisome long-term side effects of high-dose chemotherapy," said lead author Daniela Cardinale, M.D., deputy director of the cardiology unit at the European Institute of Oncology in Milan, Italy. "Therefore, it is important to identify biochemical markers that might indicate which patients are at greatest risk and how severe their heart disease might be."

TNI is a protein present exclusively in heart cells. The TNI blood concentration is a well-established marker of heart muscle injury that's widely used to diagnose and treat heart attacks and other acute coronary syndromes.

"Our study is the first to clearly show, in an adult population, that the risk of cardiac events in cancer patients can be predicted by evaluating the TNI release pattern after chemotherapy," Cardinale said.

In cancer patients who have had chemotherapy, physicians usually use extensive testing and expensive monitoring equipment to identify which patients may have cardiac toxicity, Cardinale said. These methods "have low sensitivity, poor predictive value and, in some cases, technical limitations. Moreover, these methods identify cardiac damage only when it has already occurred and, in most cases, is not reversible," she said. "Evaluating TNI value after chemotherapy is an easy, non-invasive, low-cost method that allows us to categorize the risk of cardiac events in cancer patients in the three years following chemotherapy."

Researchers took blood samples of 703 cancer patients to measure TNI soon after high-dose chemotherapy and one month later.
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
17-May-2004