Cardiovascular adverse events associated with immune checkpoint inhibitors: A retrospective multicenter cohort study

作者：Yi Zheng, Ziliang Chen, Wenhua Song, Yu Xu, Zhiqiang Zhao, Yihong Sun, Yuanyuan Wang, Xuhong Geng, Jun Zhao, Xiaowei Zhang, Yanmin Xu, Jeffrey Shi Kai Chan, Gary Tse, Guangping Li, Lili Hong, Tong Liu · 发表于：Cancer Medicine · 年份：2024 · DOI：10.1002/cam4.7233 · 被引用次数：14 · 研究领域：Cancer Immunotherapy and Biomarkers、Chemotherapy-induced cardiotoxicity and mitigation、Lung Cancer Research Studies

BACKGROUND: Over the past decade, immune checkpoint inhibitors (ICIs) have significantly transformed cancer treatment. However, ICIs inevitably may cause a spectrum of immune-related adverse events, among which cardiovascular toxicity, particularly myocarditis, while infrequent, has garnered increasing attention due to its high fatality rate. METHODS: We conducted a multicenter retrospective study to characterize ICI-associated cardiovascular adverse events. Logistic regression was performed to explore the risk factors for the development of myocarditis and severe myocarditis. Receiver operating characteristic curves were conducted to assess the diagnostic abilities of cardiac biomarkers to distinguish different cardiovascular toxicities, and the performance and calibration were evaluated using Hosmer-Lemeshow test. RESULTS: Forty-four patients were identified, including thirty-five myocarditis, five heart failure, three arrhythmias, and one myocardial infarction. Compared with other patients, myocarditis patients had higher cardiac troponin-I (cTnI) levels (p < 0.001), higher creatine kinase levels (p = 0.003), higher creatine kinase isoenzyme-MB (CK-MB) levels (p = 0.013), and shorter time to the incidence of adverse cardiovascular events (p = 0.022) after ICI treatment. Twenty-one patients (60%) were classified as severe myocarditis, and they presented higher cardiac troponin I (cTnI) levels (p = 0.013), higher N-terminal pro-B-type natriuretic peptide levels (p = 0.031), ...