Key result
Irradiation to major portions of the heart was associated with a rise in CPK in 33.3% of patients, which may reflect radiation-induced myocardial damage, whereas other enzymes were not useful.
Why the study?
Does radiotherapy to the heart cause changes in serum enzymes indicative of myocardial damage compared to noncardiac radiotherapy?
Cohort (n=45)
Does radiotherapy to the heart cause changes in serum enzymes indicative of myocardial damage compared to noncardiac radiotherapy?
Absolute Event Rate: 33.3% vs 0%
Serum CPK may be a useful biomarker to detect radiation-induced myocardial damage, whereas LDH, SGOT, and SGPT are non-specific in patients with neoplastic disease.
CPK rise after cardiac irradiation may indicate myocardial injury but should not yet change practice; this Level 3 association leaves open biomarker utility pending prospective validation.
Twenty-one patients receiving irradiation to major portions of the heart and 24 patients receiving noncardiac irradiation had serial determinations of serum enzymes including lactic acid dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and creatine phosphokinase (CPK) before, during, and after therapy. The following conclusions were reached: (1) the serum LDH and SGOT values are not useful to detect radiation-induced myocardial damage since they (as well as the SGPT) are frequently abnormal and likely to reflect a variety of complications related to the neoplastic disease itself; (2) the CPK remains normal in patients receiving irradiation to various tumors, including large areas of skeletal muscle and the right border of the heart, but excluding the major muscular portion of the heart; and (3) a rise in CPK value, noted in five patients during and in two patients following irradiation to the heart, may reflect radiationinduced myocardial damage.
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Franco M. Muggia (1970) conducted a cohort in Neoplastic disease (n=45). Irradiation to major portions of the heart vs. Noncardiac irradiation was evaluated on Rise in CPK value. Irradiation to major portions of the heart was associated with a rise in CPK in 33.3% of patients, which may reflect radiation-induced myocardial damage, whereas other enzymes were not useful.
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