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Protein marker predicts possible heart damage after chemotherapy

TNI values higher than 0.08 nanograms per milliliter (ng/mL) were considered TNI "positive," while lower values were TNI "negative." They found that 145 patients (21 percent) were TNI positive right after chemotherapy, and 63 patients (9 percent) were positive immediately after chemotherapy and one month later.

The researchers found no significant reduction in heart function at the three-year follow-up in patients who were TNI negative. These patients had only a 1 percent incidence of cardiac events, such as heart attacks.

In contrast, the cardiac event incidence was 37 percent among the patients who were TNI positive immediately after chemotherapy and 84 percent among those who remained positive a month later.

Cardinale said the study has several important implications for cancer treatment:

  • TNI categorizes heart disease risk early, long before impairment in heart function and symptoms develop, and when many preventive treatments would probably help prevent long-term health effects.
  • TNI could assess and monitor the safety and effectiveness of different treatments.
  • Heart-protective therapies that might limit or prevent the TNI rise after chemotherapy, and heart treatments that interfere with TNI persistence could improve the future heart health of these patients.

"The results of this study provide a rational need for doctors to use this marker to guide them in their cardiac evaluations and treatments of high-dose chemotherapy patients," Cardinale said.

Co-authors are: Maria T. Sandri, M.D.; Alessandro Colombo, M.D.; Nicola Colombo, M.D.; Marina Boeri, M.S.; Giuseppina Lamantia, M.D.; Maurizio Civelli, M.D.; Fedro Peccatori, M.D.; Giovanni Martinelli, M.D.; Cesare Fiorentini, M.D.; and Carlo M. Cipolla, M.D.


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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
17-May-2004


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