Troponin Screening and Major Cardiovascular Adverse Events During Immune Checkpoint Inhibitor Therapy

Does screening for troponin level elevation among patients with severe cancer stratify risk for immune checkpoint inhibitor (ICI)–associated myocarditis compared with no screening?In this cohort study including 859 patients with cancer, routine troponin screening was associated with lower mortality and major adverse cardiovascular events (MACEs) in multivariable models, but no reduction in adjudicated MACEs after competing risk analysis or propensity score matching.These findings support risk-adapted troponin screening based on baseline risk for ICI-associated cardiomyotoxicity (but not atherosclerosis risk) and clinical symptoms and suggest that screening for cardiovascular immune-related toxic effects should not rely on troponin levels alone.

Corresponding Author: Mariana Mirabel, MD, PhD, Department of Cardiology, Institut Montsouris, 42 Boulevard Jourdan, 75014 Paris, France (mariana.mirabel@imm.fr).

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