Troponin I as a marker of cardiac toxicity in acute colchicine overdose

Abstract Anthracyclines (AC) still constitute the mainstay of the 1st line treatment in lymphoma: their use, however, is limited by the occurrence of Cardiac Toxicity (CT). The exact prevalence of AC CT occurring after widely used regimens such as R-CHOP or ABVD is unknown and there is uncertainty about the best monitoring method and possible prophylactic or therapeutic interventions. METHODS: We started a prospective observational trial in lymphoma patients undergoing treatment with conventional or liposomal AC. We used a comprehensive approach to monitor for AC CT, using a telemedicine(TM) system integrating echocardiography, ECG and biomarkers (Troponin I - TnI). RESULTS: In this final analysis, 95 patients completed the planned treatment (52 males and 43 females). Median age was 56.03 years (range 19.1 to 78.5 years), and 36 patients were > 65 years. 23 were HL and 72 NHL (DLBCL was the most represented subtype with 47 cases). Liposomal AC was used in 31 patients and classical AC in 64, with mean cumulative doses of 283.33 and 272.76 mg/sqm, respectively. 10/95 patients (11%) developed a TnI rise above 0.08 ng/ml and 39/95 (41%) above 0.03 ng/ml. With both cut-offs, the rises occurred more frequently at cumulative doses >200 mg/sqm. The major arising occurred in the group underwent classical AC, while in the group underwent liposomal AC although the value before first infusion was in 10% more than 0.03 at the cumulative dose of 300 mg /sqm there's a plateau of troponin value. Thanks to this monitoring system we noticed 2 Acute cardiac toxicity events with resolution in 100% of cases. Furthermore in those cases where has registered a subclinical CT has begun a prompt Cardiological therapy by ACE inhibitors and Beta Blocker to reduce the relative risk of Cardiological events. CONCLUSIONS: Even with low cumulative doses, with a median follow up of 13 months, subclinical signs of AC CT were found in at least 11% of patients. The use of liposomal AC allow the safe treatment of patients with a previous heart disease diagnosis rather it seem protective in the higher cumulative doses. A longer follow up will be able to clarify the impact of arising of TnI more than 0.03 and 0.08 on the developing of AC CT in all our series. On the basis of our experience a multicentric trial has begun on behalf Italian Lymphoma Foundation (FIL) In a low-risk setting for AC CT, a monitoring strategy combining clinical, imaging, instrumental and biomarker data seems to enhance the sensitivity of separate methods. This strategy is feasible and resource-saving thanks to the integration in a TM system. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Protective Effect of Kolaviron on Cyclophosphamide-Induced Cardiac Toxicity in Rats

Journal of Evidence-Based Integrative Medicine ◽

10.1177/2156587218757649 ◽

2018 ◽

Vol 23 ◽

pp. 215658721875764 ◽

Cited By ~ 21

Author(s):

Joseph Gbenga Omole ◽

Oladele Abiodun Ayoka ◽

Quadri Kunle Alabi ◽

Modinat Adebukola Adefisayo ◽

Muritala Abiola Asafa ◽

...

Keyword(s):

Body Weight ◽

Protective Effect ◽

Food Consumption ◽

Troponin I ◽

Cardiac Toxicity ◽

Heart Weight ◽

Garcinia Kola ◽

Cardiac Tissues ◽

Therapeutic Uses ◽

Group I

Background. Cyclophosphamide (CP) is a nitrogen mustard alkylating drug used for the treatment of chronic and acute malignant lymphomas, myeloma, leukemia, neuroblastoma, adenocarcinoma, retinoblastoma, breast carcinoma, and immunosuppressive therapy. Despite its vast therapeutic uses, it is known to cause severe cardiac toxicity. Kolaviron (KV), a Garcinia kola seed extract containing a mixture of flavonoids, is reputed for its antioxidant and membrane stabilizing properties. Objective. This study investigated the protective effect of KV on CP-induced cardiotoxicity in rats. Methods. Thirty rats were used, and they were divided into 6 groups of 5 rats each. Group I received 2 mL/kg propylene glycol orally for 14 days; group II received CP (50 mg/kg/d, intraperitoneally [i.p.]) for 3 days; groups III and IV received 200 and 400 mg/kg/d KV, respectively, orally for 14 days and groups V and VI were pretreated with 200 and 400 mg/kg/d KV, respectively, orally for 14 days followed by CP (50 mg/kg/d, i.p.) for 3 days. Results. CP treatment resulted in a significantly lower food consumption and body weight in rats. The lactate dehydrogenase and creatine kinase enzymes in cardiac tissues of rats treated with CP were significantly higher. In cardiac tissues, 3-day doses of CP resulted in significantly higher heart weight, cardiac troponin I, myeloperoxidase, malondialdehyde, hydrogen peroxide and lower superoxide dismutase, catalase, glutathione peroxidase activities, and reduced glutathione levels. Histological examination of cardiac tissues showed sign of necrosis of myocardium after CP treatment. However, administration of KV at 200 and 400 mg/kg for 14 days prior to CP treatment, increase food consumption, body weight, and attenuates the biochemical and histological changes induced by CP. Conclusions. These results revealed that KV attenuates CP-induced cardiotoxicity by inhibiting oxidative stress and preserving the activity of antioxidant enzymes.

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Natriuretic Peptides and Troponin I Do Not Predict Chemotherapy-Induced Cardiac Toxicity

Journal of Cardiovascular Diseases & Diagnosis ◽

10.4172/2329-9517.1000140 ◽

2014 ◽

Vol 02 (01) ◽

Cited By ~ 1

Author(s):

Katja Jungandreas

Keyword(s):

Natriuretic Peptides ◽

Troponin I ◽

Cardiac Toxicity

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Cardiac Toxicity From Phenylpropanolamine Overdose in a Dog

Journal of the American Animal Hospital Association ◽

10.5326/0410413 ◽

2005 ◽

Vol 41 (6) ◽

pp. 413-420 ◽

Cited By ~ 14

Author(s):

John M. Crandell ◽

Wendy A. Ware

Keyword(s):

Ventricular Tachycardia ◽

Diagnostic Tests ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Toxicity ◽

Interventricular Septum ◽

Myocardial Necrosis ◽

Left Ventricular ◽

Left Ventricular Dilatation ◽

Biochemical Abnormalities

A 5-year-old, 29-kg, female Labrador retriever developed tachypnea, tachycardia, and ataxia following ingestion of approximately 48 mg/kg of phenylpropanolamine. Initial diagnostic tests showed multiform ventricular tachycardia, left ventricular dilatation with a focal dyskinetic region in the dorsal interventricular septum, and elevations in creatinine kinase and cardiac troponin I. All abnormalities resolved within 6 months. The transient electrocardiographic, echocardiographic, and biochemical abnormalities were consistent with myocardial necrosis from infarction or direct catecholamine-induced myocardial toxicity.

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Cardiac Toxicity Associated with Immune Checkpoint Inhibitors: Case Series and Review of the Literature

Case Reports in Oncology ◽

10.1159/000498985 ◽

2019 ◽

Vol 12 (1) ◽

pp. 260-276 ◽

Cited By ~ 17

Author(s):

Nikhil Agrawal ◽

Arjun Khunger ◽

Pankit Vachhani ◽

Teresa A. Colvin ◽

Alexander Hattoum ◽

...

Keyword(s):

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Troponin I ◽

Cardiac Toxicity ◽

Checkpoint Inhibitors ◽

Case Reports ◽

Case Series ◽

Fulminant Myocarditis ◽

Comprehensive Cancer Center ◽

Cancer Center

The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormalities of the heart and even fulminant myocarditis. Although rare, myocarditis is a potentially fatal adverse effect of ICI therapy. We present a series of five cases of ICI-related cardio-toxicity diagnosed and managed at Roswell Park Comprehensive Cancer Center along with a review of published case reports in the literature. Our series highlights the importance of high clinical suspicion, early diagnosis of myocarditis, and prompt initiation of immunosuppressive therapy.

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Cytopathology of Cardiac Tissue from Daunomycin-Treated Mice

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100066802 ◽

1971 ◽

Vol 29 ◽

pp. 550-551

Author(s):

Robert H. Liss ◽

Frances A. Cotton

Keyword(s):

Cardiac Tissue ◽

Cardiac Toxicity ◽

Drug Distribution ◽

Personal Communication ◽

Intravenous Dose ◽

Single Intravenous Dose ◽

Physiologic Saline ◽

Histopathologic Changes ◽

Distribution Studies ◽

Lung And Kidney

Daunomycin, an antibiotic used in the clinical management of acute leukemia, produces a delayed, lethal cardiac toxicity. The lethality is dose and schedule dependent; histopathologic changes induced by the drug have been described in heart, lung, and kidney from hamsters in both single and multiple dose studies. Mice given a single intravenous dose of daunomycin (10 mg/kg) die 6-7 days later. Drug distribution studies indicate that the rodents excrete most of a single dose of the drug as daunomycin and metabolite within 48 hours after dosage (M. A. Asbell, personal communication).Myocardium from the ventricles of 6 moribund BDF1 mice which had received a single intravenous dose of daunomycin (10 mg/kg), and from controls dosed with physiologic saline, was fixed in glutaraldehyde and prepared for electron microscopy.

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