{
  "abstract": "Background\n\nTroponin surveillance may facilitate early detection of immune checkpoint inhibitor (ICI)-associated myocarditis, but mild elevations and baseline abnormalities complicate interpretation. We assessed early post-ICI troponin I (TnI) dynamics and the performance characteristics of clinically applicable peak TnI thresholds within 3 months of ICI initiation.Methods and results\n\nWe analyzed 281 participants from a cardio-oncology surveillance program. TnI was measured at predefined intervals. Using peak TnI levels within 3 months, we evaluated the performance characteristics of candidate TnI thresholds for identifying adjudicated clinically significant TnI elevation associated with clinically meaningful conditions (e.g., ICI-associated myocarditis) at cut-offs of 50, 100, and 500 pg/mL. Eleven (3.9%) patients had elevated baseline TnI. Within 3 months, clinically significant TnI elevation occurred in 5 (1.8%) patients: ICI-associated myocarditis (n=2); immune-related myositis (n=1); pulmonary embolism (n=1); and seizures (n=1). A 50 pg/mL cut-off yielded 100% sensitivity, 96.0% specificity, 31.3% positive predictive value, and 100% negative predictive value. A 100 pg/mL cut-off demonstrated 100% sensitivity, 99.6% specificity, 83.3% positive predictive value, and 100% negative predictive value. A 500 pg/mL cut-off yielded 40.0% sensitivity and 100% specificity.Conclusions\n\nIn this exploratory study, a peak TnI threshold of 100 pg/mL within 3 months identified all clinically significant events with high specificity. This threshold may serve as a pragmatic trigger for expedited evaluation of myocarditis and alternative etiologies.",
  "abstract_shown": true,
  "affiliations": [
    "Cardiovascular Center, International University of Health and Welfare Mita Hospital Tokyo Japan.",
    "Pulmonary Hypertension Center, International University of Health and Welfare Mita Hospital Tokyo Japan.",
    "Department of Cardiology, International University of Health and Welfare School of Medicine Chiba Japan.",
    "Department of Pathology, International University of Health and Welfare Mita Hospital Tokyo Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hiroyuki Fujii"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Yuichi Tamura"
    },
    {
      "affs": [
        0
      ],
      "name": "Masao Daimon"
    },
    {
      "affs": [
        1
      ],
      "name": "Yudai Tamura"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Sarasa Isobe"
    },
    {
      "affs": [
        0
      ],
      "name": "Yukihiro Yamaguchi"
    },
    {
      "affs": [
        0
      ],
      "name": "Jin Iwasawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Shigeki Kimura"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Masahiko Goya"
    },
    {
      "affs": [
        3
      ],
      "name": "Shinsuke Aida"
    },
    {
      "affs": [
        2
      ],
      "name": "Issei Komuro"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6131m0a2kf2x1.bib",
  "cited_by": 0,
  "doi": "10.1253/circrep.cr-26-0251",
  "fulltext_url": "https://europepmc.org/articles/PMC13747982",
  "id": "6131m0a2kf2x1",
  "issns": [
    "2434-0790"
  ],
  "landing_url": "https://europepmc.org/article/MED/43010971",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Onco-Cardiology"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2730|Cancer Immunotherapy and Biomarkers"
    ]
  ],
  "openalex": "W7212793772",
  "pdf_url": "https://europepmc.org/articles/PMC13747982?pdf=render",
  "pmcid": "PMC13747982",
  "pmid": "43010971",
  "published": "2026-09-15",
  "publisher": "The Japanese Circulation Society",
  "ris": "https://research.draconitic.com/paper/6131m0a2kf2x1.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T15:22:43Z",
      "native_id": "MED:43010971",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/43010971"
    },
    {
      "first_seen": "2026-11-13T12:25:34Z",
      "native_id": "PMC13747982",
      "source": "pmc",
      "url": "https://doi.org/10.1253/circrep.cr-26-0251"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Cancer Immunotherapy and Biomarkers",
      "subfield": "oncology"
    }
  ],
  "title": "Troponin I Surveillance to Risk-Stratify Early Events After Immune Checkpoint Inhibitor Initiation.",
  "title_text": "Troponin I Surveillance to Risk-Stratify Early Events After Immune Checkpoint Inhibitor Initiation.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:25:34Z",
  "url": "https://research.draconitic.com/paper/6131m0a2kf2x1",
  "venue": "Circulation reports",
  "versions": []
}