High-Sensitivity Troponin I: A Poor Predictor of Anthracycline-Induced Left Ventricular Dysfunction?

Introduction: The Cardio-Oncology Dilemma

Anthracyclines, including doxorubicin and epirubicin, remain a cornerstone of chemotherapy for various malignancies, notably breast cancer and lymphomas. However, their clinical utility is frequently shadowed by the risk of dose-dependent, irreversible cardiotoxicity. For decades, clinicians have sought a reliable biomarker to identify patients at the highest risk of developing left ventricular (LV) dysfunction before overt heart failure occurs. High-sensitivity cardiac troponin I (hs-cTnI) has emerged as a leading candidate, given its ability to detect minute levels of myocardial injury. Current guidelines often suggest troponin monitoring for risk stratification. However, the exact relationship between these biomarker elevations and long-term functional changes remains a subject of intense clinical debate.

The Cardiac CARE Trial: Study Design and Objectives

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