{
  "abstract": "Background: Serial troponin monitoring is used during immune checkpoint inhibitor (ICI) therapy, but guidelines do not specify whether high-sensitivity cardiac troponin I (hs-cTnI) or T (hs-cTnT) should be measured. Unlike cardiac-specific hs-cTnI, hs-cTnT can rise from noncardiac sources.\n\nObjectives: This study sought to determine the prevalence and temporal stability of hs-cTnT/hs-cTnI discordance, identify clinical correlates, and evaluate prognostic implications in ambulatory ICI-treated patients.\n\nMethods: In this prospective single-center cohort, patients starting ICI therapy underwent paired hs-cTnT (Roche Elecsys) and hs-cTnI (Siemens Atellica) measurements in the same banked samples at baseline and 1 month. Patients with adjudicated ICI-associated myocarditis or myositis were excluded by design.\n\nResults: Among 433 patients with paired baseline measurements, hs-cTnT was elevated in 37.9% and hs-cTnI in 1.8%; 158 (36.5%) were discordant (elevated hs-cTnT, normal hs-cTnI), and 267 (61.7%) had normal levels of both (κ = 0.036). Among 329 patients with paired data at baseline and 1 month, discordance prevalence was unchanged (38.3% vs 38.0%; McNemar P > 0.99). Independent correlates were older age, male sex, and chronic kidney disease (all P < 0.05). Over a median follow-up of 30.1 months (reverse Kaplan-Meier), elevated hs-cTnT was associated with all-cause mortality (adjusted HR: 1.35; 95% CI: 1.00-1.81; P = 0.048); only 8 of 231 deaths (3.5%) were cardiac.\n\nConclusions: In ambulatory patients with cancer receiving ICI therapy, over one-third had elevated hs-cTnT with normal hs-cTnI: a stable, nonspecific pattern present before ICI exposure and consistent with noncardiac sources rather than acute cardiac injury. hs-cTnI is the more cardiac-specific assay; paired baseline measurement of both troponins may help contextualize later elevations when myocarditis is suspected.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA",
    "School of Nursing, University of Washington, Seattle, Washington, USA",
    "John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA",
    "Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA",
    "Division of Cardiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Anis Ismail"
    },
    {
      "affs": [
        1
      ],
      "name": "Alexi Vasbinder"
    },
    {
      "affs": [
        2
      ],
      "name": "Bobby Bobby"
    },
    {
      "affs": [
        2
      ],
      "name": "McKenna de Bever"
    },
    {
      "affs": [
        3
      ],
      "name": "Aidan Vosooghi"
    },
    {
      "affs": [
        4
      ],
      "name": "Valeria Pena-Valentin"
    },
    {
      "affs": [
        3
      ],
      "name": "Lihua Shu"
    },
    {
      "affs": [
        3
      ],
      "name": "Sujay Kalathoor"
    },
    {
      "affs": [
        0
      ],
      "name": "Ramya Elangovan"
    },
    {
      "affs": [
        4
      ],
      "name": "Rachel Jones"
    },
    {
      "affs": [
        4
      ],
      "name": "Julia Skibniewska"
    },
    {
      "affs": [
        4
      ],
      "name": "Ian Pizzo"
    },
    {
      "affs": [
        4
      ],
      "name": "Tonimarie Catalan"
    },
    {
      "affs": [
        0
      ],
      "name": "Theresa Farhat"
    },
    {
      "affs": [
        0
      ],
      "name": "Pennelope Kunkle"
    },
    {
      "affs": [
        4
      ],
      "name": "Monika Leja"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Salim S. Hayek"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7jfmrbsgfv5dc.bib",
  "cited_by": 1,
  "doi": "10.1016/j.jaccao.2026.07.012",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699023/",
  "id": "7jfmrbsgfv5dc",
  "issns": [
    "2666-0873"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccao.2026.07.012",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "heading",
      "Part 1: Cardio-Oncology & Immunology Special Issue"
    ],
    [
      "openalex",
      "2705|Chemotherapy-induced cardiotoxicity and mitigation"
    ]
  ],
  "openalex": "W7223019773",
  "pdf_url": "https://europepmc.org/articles/PMC13699023?pdf=render",
  "pmcid": "PMC13699023",
  "pmid": "42904625",
  "published": "2026-10-01",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/7jfmrbsgfv5dc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:42Z",
      "native_id": "PMC13699023",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccao.2026.07.012"
    },
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42904625",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42904625"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Chemotherapy-induced cardiotoxicity and mitigation",
      "subfield": "cardiovascular"
    }
  ],
  "title": "High-Sensitivity Cardiac Troponin T and I Discordance in Patients Receiving Immune Checkpoint Inhibitors",
  "title_text": "High-Sensitivity Cardiac Troponin T and I Discordance in Patients Receiving Immune Checkpoint Inhibitors",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:35:39Z",
  "url": "https://research.draconitic.com/paper/7jfmrbsgfv5dc",
  "venue": "JACC: CardioOncology",
  "versions": []
}