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Assessing the risk of cardiovascular events in patients receiving immune checkpoint inhibitors

María Torrente1,2, Mariola Blanco1, Fabio Franco1

  • 1Department of Medical Oncology, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.

Frontiers in Cardiovascular Medicine
|December 19, 2022
PubMed
Abstract

Insights

Cardiac events (CE) from immune checkpoint inhibitors (ICIs) are more common than previously thought. Risk factors include age, prior heart conditions, and previous immune-related adverse events, necessitating proactive cardiac evaluation.

Area of Science:

  • Oncology
  • Cardiology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer therapy.
  • ICIs can cause immune-related adverse events, including potentially fatal cardiotoxicity.
  • The incidence of ICI-related cardiotoxicity is likely underestimated.

Purpose of the Study:

  • To determine the incidence of cardiac events in patients receiving ICIs.
  • To identify risk factors associated with ICI-induced cardiotoxicity.

Main Methods:

  • Retrospective single-institution study.
  • Analysis of 378 patients treated with ICIs.
  • Primary outcomes: cardiac events and cardiovascular death.

Main Results:

  • The incidence of cardiac events was 16.7% over a median follow-up of 50.5 months.
  • Significant risk factors for cardiac events included older age, history of arrhythmia or ischemic heart disease, and prior immune-related adverse events.

Conclusions:

  • Cardiac events during ICI therapy are more frequent than recognized.
  • Pre-treatment cardiovascular assessment is crucial, particularly for high-risk individuals.
  • A multidisciplinary cardio-oncology approach is recommended for managing ICI-related cardiotoxicity.
Keywords:
cardiotoxicitycardiovascular eventimmune checkpoint inhibitorsmyocarditisrisk factors

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