Evidence map›Paper›PMID 40894847›Full record

ArticleCJC open2025

Real-Life Management of Elevated Troponin Level in Patients Treated with Immune Checkpoint Inhibitors.

Lior Zornitzki, Dana Viskin, Ophir Freund, Ido Wolf, Anna Rozenfeld Hemed, Noam Weiss, Shir Frydman, Maor Tzuberi, Shafik Khoury, Ofer Havakuk and 3 more

Abstract read
In one paragraph

Article in CJC open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Lior ZornitzkiDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Dana ViskinDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Ophir FreundTel Aviv School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ido WolfTel Aviv School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Anna Rozenfeld HemedTel Aviv School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Noam WeissDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Shir FrydmanDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Maor TzuberiDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Shafik KhouryDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Ofer HavakukDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Yan TopilskyDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Shmuel BanaiDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Michal Laufer-PerlDivision of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the clinical outcomes of cancer. Nevertheless, their use may lead to myocardial injury. The 2022 European Society of Cardiology cardio-oncology guidelines recommend routine follow-up of troponin level; however, current guidelines do not provide specific protocols for managing elevated troponin levels during ICI therapy. We aimed to describe the real-life assessment of patients treated with ICIs, presenting with an elevated high-sensitivity troponin I (hs-TnI) level following therapy. Methods: Tel Aviv Sourasky Medical Center has implemented a routine follow-up of hs-TnI level measurement during ICI therapy. We performed a retrospective analysis evaluating the clinical assessment and management of patients presenting with an elevated hs-Tnl level (> 50 ng/L) following therapy. Results: Among 455 patients performing baseline and follow-up hs-TnI measurements, 50 patients (11%) presented with an elevated hs-TnI level (median 159 ng/L; interquartile range 76-362) following ICI therapy. All patients underwent an electrocardiogram, showing changes in 5 patients (10%). Among 24 patients (48%) who received echocardiography, 4 (8%) showed abnormalities. A cardiology consultation was ordered for 17 patients (34%), and none received cardiac magnetic resonance imaging or coronary angiography. A total of 13 patients (26%) were diagnosed with probable or possible myocarditis, resulting in corticosteroid therapy and discontinuation of ICI therapy in 84% and 92% of the patients, respectively. Only 2 patients reinitiated ICI therapy at a later stage. Conclusions: We describe for the first time the management of elevated hs-TnI levels following ICI therapy, which was diagnosed in routine serial surveillance. We found a wide diversity in management, low cardiology involvement, and high interruption of therapy, emphasizing the need for standardized protocol management guidelines.

Identifiers

PMID40894847
PMCPMC12399054

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.