Cardinale D, et al. - Cancer patients with troponin elevation, which may be an early indicator of cardiac injury after chemotherapy, could benefit from enalapril therapy, however whether there is a preventative role for enalapril is unknown. Researchers compared two strategies of giving enalapril in cancer patients who received anthracycline-containing chemotherapy (CT): enalapril in all patients started before chemotherapy (prevention arm), and enalapril started only in patients with an increase in troponin during or after CT (troponin-triggered arm). The incidence of troponin elevation above the threshold was the primary outcome. In the prevention and in the troponin-triggered group, the incidence of troponin elevation was 23% and 26%, respectively. Overall, troponins can be raised with low cumulative doses of anthracyclines in adult patients with low cardiovascular risk, with no differences between the two strategies of giving enalapril. A troponin-triggered strategy may be more convenient taking account of a benefit of enalapril in the prevention of LV dysfunction.