Clinical Value of Cardiac Troponin I in Assessing Anthracycline-Induced Cardiotoxicity in Postoperative Breast Cancer Patients.

[OBJECTIVE] To investigate the clinical value of high-sensitivity cardiac troponin I (hs-cTnI) in evaluating chemotherapy-related cardiac dysfunction (CTRCD) induced by anthracyclines in postoperative breast cancer patients.

[METHODS] A retrospective study was conducted including 180 postoperative breast cancer patients treated at our hospital from August 2021 to August 2024. All patients completed six cycles of the cyclophosphamide-epirubicin-fluorouracil (CEF) regimen. According to the Chinese Society of Clinical Oncology (CSCO) guideline criteria, patients were divided into a cardiotoxicity group (n = 50) and a non-cardiotoxicity group (n = 130). Serum hs-cTnI and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, as well as left ventricular ejection fraction (LVEF) measured by echocardiography, were dynamically monitored before chemotherapy (T) and after each chemotherapy cycle (T-T). The predictive value of each marker for CTRCD was evaluated using receiver operating characteristic (ROC) curves.

[RESULTS] Compared with the non-cardiotoxicity group, the cardiotoxicity group showed significantly higher serum hs-cTnI and NT-proBNP levels from T onward, with progressive increases over chemotherapy cycles (P < 0.01), while LVEF progressively decreased (P < 0.01). ROC analysis indicated that serum hs-cTnI at the third chemotherapy cycle (T) had an area under the curve (AUC) of 0.957 (95% CI: 0.905-0.988) for predicting CTRCD, with an optimal cutoff value of >1358.5 pg/mL, yielding a sensitivity of 92.00% and specificity of 91.54%. Its predictive performance was significantly superior to that of NT-proBNP at the same time point [AUC = 0.684 (95% CI: 0.590-0.763)].

[CONCLUSION] Serum hs-cTnI is a highly sensitive and specific biomarker for the early and dynamic monitoring of anthracycline-induced cardiotoxicity. The hs-cTnI level at mid-chemotherapy (third cycle) has excellent predictive value for CTRCD, facilitating early identification of high-risk patients and timely clinical intervention.