免疫チェックポイント阻害剤と心血管疾患と動脈硬化プラークとの関連

Zsofia D Drobni^1,2, Raza M Alvi¹, Jana Taron^1,3

¹Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology (Z.D.D., R.M.A., J.T., A.Z., V.K.R., S.E.H., H.K.G., J.G., T.M., U.H., T.G.N.), Massachusetts General Hospital, Harvard Medical School, Boston.

Circulation

|October 2, 2020

まとめ

免疫チェックポイント阻害剤 (ICI) は,動脈硬化症の加速により,心血管疾患のリスクを有意に増加させる. ICIの患者は,注意深い心血管リスク管理とモニタリングを必要とします.

科学分野:

心臓病科
腫瘍学
免疫学

背景:

免疫チェックポイント阻害剤 (ICI) は,様々ながんの治療にますます使用されています.
基礎研究によると免疫チェックポイントは動脈硬化症を制御します
この研究では,ICI,動脈硬化,心血管疾患との関連を調査しています.

研究の目的:

ICIが加速度性動脈硬化症と関連しているかどうかを判断する.
ICIを受けた患者の動脈硬化に関連する心血管疾患のリスクを評価する.

主な方法:

2842人の患者と2842人の対照群を対象としたマッチングコホート研究.
ICI治療の前と後の2年間を評価したケースクロスオーバー分析.
40人の患者でプラークの進行を評価した.

主要な成果:

ICIの使用は,心血管疾患の3倍のリスクに関連していた (HR, 3. 3).
動脈硬化性プラークの進行は,ICIを開始した後で3倍以上 (年間2. 1%から6. 7%まで) 増加しました.
スタチンまたはコルチコステロイドの併用は関連性を弱めた.

結論:

心血管疾患はICIの開始後により頻繁に発生し,おそらく加速した動脈硬化によるものです.
ICIの患者は,心血管の危険因子の最適化管理と心血管の危険に対する認識を高めることが必要です.

キーワード:

動脈硬化症免疫調節プラーク,動脈硬化

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