However, despite increasing efforts to identify early predictors of cardiotoxicity and growing evidence of the importance of cardiac biomarkers for this purpose, large randomized multicenter clinical

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

• Impact of Previous Cardiac Surgery on Outcomes After Tricuspid Valve Transcatheter Edge-to-Edge Repair: Insights from EuroTR  (2026) · doi

  This study is subject to the limitations of its observational and retrospective design. Although derived from a large multicenter registry, procedural and echocardiographic data were site-reported and not adjudicated by a core lab- oratory. Details on previous cardiac surgery were limited, precluding stratified analyses by surgical type or timing. As such, findings should be interpreted with caution and warrant validation in prospective studies.

  Keywords: subject limitations observational retrospective design derived large multicenter registry procedural echocardiographic site reported adjudicated core
• The usefulness of C-reactive protein for the prediction of post-infarct left ventricular systolic dysfunction and heart failure (2018) · doi

  This may be due to conflicting results reported in existing studies related to various limitations in study designs, such as retrospective case control design, prior myocardial damage, CRP measurement with low-sensitivity assays, non-homogenous populations with acute coronary syndromes, different treatment strategies, small sample sizes, and the lack of left ventricular ejection fraction assessment and long-term clinical and echocardiographic monitoring.

  Keywords: conflicting reported existing related various limitations designs retrospective case control design prior myocardial damage measurement
• How to identify anthracycline-induced cardiotoxicity early and reduce its clinical impact in everyday practice (2021) · doi

  However, despite increasing efforts to identify early predictors of cardiotoxicity and growing evidence of the importance of cardiac biomarkers for this purpose, large randomized multicenter clinical trials are still lacking and so there is still no scientific agreement on the best approach for early diagnosis.

  Keywords: early still despite increasing efforts identify predictors cardiotoxicity growing evidence importance cardiac biomarkers purpose large