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Cardiac Imaging and Diagnostics / Chemotherapy-induced Cardiotoxicity and Mitigation · Journal article
Journal of Cardiovascular Development and Disease · September 8, 2026
Encouraging direction, but not yet definitive.
This retrospective study developed and internally validated a nomogram combining thoracic aortic calcification, baseline troponin, lipid profile, and HER2-directed therapy status to predict hs-cTnT elevation (>14 ng/L) within 6 months of breast cancer treatment. The nomogram achieved good discrimination (AUROC 0.901, concordance index 0.882) in the validation cohort and identified distinct risk strata, but external validation and hard clinical outcome data are required to establish clinical utility.
Retrospective cohort study with nomogram development and internal validation. Breast cancer patients treated at Sun Yat-sen Memorial Hospital between January 2014 and December 2021, with chest computed tomography data and at least three hs-cTnT measurements.. Intervention: Thoracic aortic calcification-based nomogram incorporating baseline hs-cTnT, high-density lipoprotein cholesterol, thoracic aortic calcification score, and anti-HER2 therapy status.. Compared with: Null; nomogram was validated internally without comparison to alternative models or clinical standards.. n = 551. Single centre: Sun Yat-sen Memorial Hospital (China).
Area under the receiver operating characteristic curve in validation cohort: 0.901 Concordance index in validation cohort: 0.882 Four independent predictors retained: baseline hs-cTnT, high-density lipoprotein cholesterol, thoracic aortic calcification score, and anti-HER2 therapy
Surrogate endpoint (troponin elevation) used rather than clinical myocardial injury events, hospitalisation, or mortality
If externally validated, this nomogram could support identification of breast cancer patients at high risk of treatment-related myocardial injury to enable targeted cardiovascular surveillance. Current evidence supports further prospective validation before clinical implementation.
A retrospective nomogram development and validation study in a single centre with good discrimination metrics (AUROC 0.901) and internal validation, but based on a surrogate endpoint (elevated troponin) rather than hard clinical outcomes, limiting generalizability.
As stated by the source record.
Quoted from the source exactly as published.
If externally validated, this nomogram could support identification of breast cancer patients at high risk of treatment-related myocardial injury to enable targeted cardiovascular surveillance. Current evidence supports further prospective validation before clinical implementation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Early identification of patients with breast cancer who are at increased risk of treatment-related myocardial injury may support individualized cardiovascular surveillance. This retrospective study included 551 patients treated at Sun Yat-sen Memorial Hospital between January 2014 and December 2021. All patients had chest computed tomography data and at least three high-sensitivity cardiac troponin T (hs-cTnT) measurements. Early myocardial injury was defined as hs-cTnT > 14 ng/L within 6 months after treatment. Patients were randomly divided into training (n = 366) and validation (n = 185) cohorts. Candidate predictors were identified using univariable Cox regression and least absolute shrinkage and selection operator regression. A multivariable Cox model was then used to construct the nomogram. Baseline hs-cTnT, high-density lipoprotein cholesterol, thoracic aortic calcification score, and anti-human epidermal growth factor receptor 2 therapy were retained as independent predictors. In the validation cohort, the nomogram showed good discrimination, with an area under the receiver operating characteristic curve of 0.901 and a concordance index of 0.882. Calibration curves indicated agreement between predicted and observed risks. Decision curve analysis suggested clinical utility, while risk stratification identified distinct groups in both cohorts (p < 0.001). This thoracic aortic calcification-based nomogram may support the identification of patients at high risk of early myocardial injury after anticancer therapy.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.