Study Highlights How Cancer Affects Diagnostic Tool Used to Detect Right Ventricular Dysfunction (RVD) in Pulmonary Embolism

In a new study, researchers have investigated the impact of cancer diagnosis on the prediction of right ventricular dysfunction (RVD) in acute pulmonary embolism (PE) patients using cardiac troponin I (cTnI). The study, entitled “Impact of cancer on the effectiveness of cardiac Troponin I to predict right ventricular dysfunction in acute pulmonary embolism,” was published in Thoracic Cancer.

Previous studies have shown that cancer patients present a higher risk of developing venous thromboembolism (VTE), a lethal disorder that includes deep vein thrombosis (DVT) and pulmonary embolism (PE), when compared to people who have never experienced an oncologic disease. After cancer itself, VTE is the main cause of mortality in cancer patients, so this disorder severely worsens prognosis.

In light of the importance of VTE events, researchers decided to study if the presence of cancer could be detrimental to the diagnosis of right ventricular dysfunction (RVD) using cTnI in patients with acute PE. Cardiac troponin I is a cardiac regulatory protein and is used as a marker of myocardial damage, and as a measurement of cardiac muscle damage. VTE events are associated with poorer survival in cancer patients, and both cTnI and RVD are important biomarkers in PE outcome prediction, making diagnostic tool effectiveness of extreme importance.

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The design of this study included 182 PE patients, of which 37 (20.3%) had an active cancer or a history of cancer disease and 145 (79.7%) had no previous or current cancer diagnosis. The patients were divided into two groups according to cancer history. Researchers analyzed cTnI levels and their correlation with a correct or incorrect right ventricular dysfunction diagnosis.

The effectiveness of diagnosis evaluation showed that for PE patients with cancer or history of cancer the risk of misclassification was not significantly different than in the group of the PE patients without cancer (25% and 24.9%, respectively). However, the cut-off value to diagnose RVD in PE patients was lower in patients without cancer, meaning that the effectiveness of cTnI to predict RVD is higher when no cancer or history of cancer is present. Researchers highlight the need for future examinations and follow-ups due to some limitations in this study, such as small number of patients and retrospective data analysis.