Immune Checkpoint Inhibitors, Atherosclerotic Cardiovascular Events, and Plaque Progression Among Women With Cancer

作者：Giselle Alexandra Suero‐Abreu, Zsófia D. Drobni, Carlos A. Gongora, Jana Taron, Júlia Karády, Hannah Gilman, Béla Merkely, Hajnalka Vágó, Zoltán V. Varga, Ryan J. Sullivan, Kerry L. Reynolds, Daniel A. Zlotoff, Borek Foldyna, Markella V. Zanni, Tomas G. Neilan · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.125.041925 · 被引用次数：4 · 研究领域：Chemotherapy-induced cardiotoxicity and mitigation、Cancer Immunotherapy and Biomarkers、Atherosclerosis and Cardiovascular Diseases

Background Immune checkpoint inhibitors (ICIs) are associated with a 3‐fold risk of atherosclerotic cardiovascular disease (ASCVD). However, the biology of atherosclerosis is different among women and men, and ASCVD risk factors among women treated with an ICI are incompletely understood. This study aimed to identify factors associated with ASCVD in women following ICIs and to characterize plaque progression. Methods In a single‐center retrospective study, clinical and cancer‐related factors were compared among women treated with ICIs who did and did not experience ASCVD. Competing risk analysis estimated the effect of ICIs on cardiovascular risk. In an imaging substudy, the rate of atherosclerotic plaque progression post‐treatment was compared between women and men. Results Among 1188 female patients treated with an ICI, 54 (5%) experienced an ASCVD with a median time to event of 174 days. Patients with ASCVD had a higher prevalence of prior myocardial infarction and coronary revascularization (15% versus 6%, P =0.007) and prior stroke (7% versus 2%, P =0.039). Competing risk analyses, adjusting for cardiovascular risk factors, revealed an almost 3‐fold increased risk of post‐ICI ASCVD in women with prior cardiovascular events (hazard ratio, 2.71 [95% CI, 1.24–5.95]; P =0.013). In an imaging study, the annual rate of plaque progression post‐ICI was 6% for total and 7% for non‐calcified plaque, with similar rates of progression observed in women and men. Conclusions In female...