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| 標題: | Clinical Features and Outcomes of Immune Checkpoint Inhibitor-Associated Cardiovascular Toxicities |
| 作者: | Wu, Nan-Chun
Feng, Yin-Hsun
Kuo, Yu Hsuan
Chen, Wei-Yu
Wu, Hong-Chang
Huang, Chien-Tai
Wang, Wen-Ching
Kang, Nai-Wen
Shih, Jhih-Yuan
Chen, Zhih-Cherng
Chang, Wei-Ting |
| 貢獻者: | Chi Mei Hospital
Chia Nan University of Pharmacy & Science, Department of Hospital and Health Care
Administration
Chi Mei Hospital
Chi Mei Hospital
Chi Mei Hospital
Chia Nan University of Pharmacy & Science
Southern Taiwan University of Science & Technology
National Cheng Kung University |
| 關鍵字: | cancer-patients
myocarditis
mechanisms
cardiology
management
diagnosis
therapy |
| 日期: | 2022 |
| 上傳時間: | 2023-12-11 13:55:40 (UTC+8) |
| 出版者: | TAIWAN SOC CARDIOLOGY |
| 摘要: | Background: Despite the increasing prevalence of therapies utilizing immune checkpoint inhibitors (ICIs), the associated cardiovascular complications have been poorly reported. Given the fatality of ICI-related complications, especially myocarditis, optimal risk stratification to predict major adverse cardio- and cerebrovascular events (MACCEs) in patients receiving ICIs is mandatory. Methods: We collected clinical data from patients receiving ICIs, and the primary outcomes were MACCEs, including myocarditis, heart failure, and ischemic stroke. Other systemic immune responses relating to ICIs were also recorded. The median follow-up duration was 3 years. Results: Among 580 patients, the incidence of MACCEs was 3.9%. Older patients, male patients, and patients with lung cancer, liver cirrhosis, or diabetes had higher risks of MACCEs. There was no significant difference between the use of PD-1/PD-L1 inhibitors or CTLA inhibitors in terms of developing cardiovascular toxicities. The development of ICI-related MACCEs was associated with worse survival. Notably, after re-review, by specialists, three patients eventually diagnosed with ICI-related myocarditis had not previously been identified. Only one was treated with pulse steroids, and none survived. The most common concomitant extracardiac immune-related adverse events were myositis/dermatitis, endocrine toxicity and hepatitis. Conclusions: Collectively, ICIs may lead to severe cardiovascular toxicities and require more attention. Early identification, proper diagnosis and prompt treatment are pivotal for improving survival. |
| 關聯: | Acta Cardiologica Sinica, v.38, pp.:39-46 |
| 顯示於類別: | [醫務管理系(所)] 期刊論文
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