Key result
High-sensitivity troponins remain integral for diagnosing and monitoring cancer therapy cardiotoxicity despite undefined optimal cut-offs.
Why the study?
Ideal cut-off points for troponins for precise diagnostic value and indications for cardiology treatment in cardio-oncology have not yet been defined.
Troponins play a critical role in cardio-oncology for risk stratification and monitoring of cancer therapy-related cardiovascular toxicity, aligning with current ESC guidelines.
Troponin monitoring in cardio-oncology lacks validated thresholds; leaves open the need for standardized cutoffs in prospective trials.
OPINION STATEMENT: Troponins are an integral part of the diagnosis of acute coronary syndromes in cardiology. It is also useful in many other acute cardiological conditions, such as acute pulmonary embolism. In cardio-oncology, it is part of the definition of either cancer disease or cancer therapy related cardiovascular toxicity. Change in troponin value is one of the diagnostic criteria for mild and moderate cancer therapy related cardiac dysfunction. Diagnosis of myocarditis is also based on troponin elevation. However, an ideal cut-off points for precise diagnostic value and indication for cardiology treatment have not yet been defined.It is still difficult to make therapeutic decisions in cardio-oncology about the initiation, intensification or modification of cardiac therapy based on the dynamics of troponin changes.
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Homotnik et al. (2026) conducted a review in Cancer therapy-related cardiovascular toxicity. Cardiac troponin monitoring was evaluated. High-sensitivity cardiac troponins are integral for diagnosing and monitoring cancer therapy-related cardiovascular toxicity, though ideal cut-off points and therapeutic decision algorithms remain undefined.
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