Is Electrocardiogram Helpful in Predicting a Rise in Troponin I as a Marker of Anthracycline Cardiotoxicity?

Objective: Screening patients on anthracycline-based chemotherapy regimens for the development of cardiotoxicity can be resource intensive. We therefore studied various traditional electrocardiogram (ECG) parameters to correlate and possibly predict the development of elevated Troponin I as a surrogate marker of anthracycline-induced cardiotoxicity. Materials and Methods: This was a single-centre prospective cohort study done between January 2014 to January 2016. Baseline ECG was compared with ECG performed after chemotherapy and different parameters were compared. Patients were divided into Troponin I positive and negative groups based on the test performed at the end of chemotherapy, using a cut-off of 0.06 ng/dL. Results: Of the 160 patients studied, 131 (81.9%) were Troponin I negative (TnI-) and 29 (18.1%) were positive (TnI+). Breast cancer accounted for 79% of all cancers in this study. Many ECG parameters were compared between the TnI- and TnI+ groups. Of them, TP segment and TP/QT showed a significant decrease in the TnI+ group. The mean (95% confidence interval) TP in the TnI- group was 162.9 ms (145.4, 180.4) and in TnI+ groups was 117.9 ms (89, 146.8) ( Conclusion: ECG parameters, such as QTcH, TP and TP/QT do not helpful predicting Troponin I elevations in patients on anthracycline-based chemotherapy. Further studies based on hard endpoints, for example, clinical systolic dysfunction occurring at one year, would give better information on their utility.