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免疫检查点抑制剂与心血管事件和动脉样斑块之间的关联
Zsofia D Drobni1,2, Raza M Alvi1, Jana Taron1,3
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
概括
通过加速动脉样硬化,免疫检查点抑制剂显著增加心血管事件的风险. 在ICI治疗的患者需要谨慎的心血管风险管理和监测.
科学领域:
- 心脏病学
- 癌症学
- 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于治疗各种癌症.
- 基本研究表明免疫检查点可以调节动脉样硬化.
- 这项研究调查了ICI,动脉样硬化和心血管事件之间的联系.
研究的目的:
- 为了确定ICI是否与加速动脉样硬化有关.
- 在接受ICI治疗的患者中评估动脉样硬化相关心血管事件的风险.
主要方法:
- 在2842名患者和2842名对照组中进行了对应的队列研究.
- 评估ICI治疗前后2年的病例交叉分析.
- 一项成像子研究评估了40名患者的斑块进展情况.
主要成果:
- 使用ICI与心血管事件的风险增加了3倍 (HR, 3. 3).
- 在开始ICI后,动脉硬性斑块的进展率增加了三倍以上 (每年2.1%至6.7%).
- 同时使用他类药物或皮质类固醇减弱了相关性.
结论:
- 在ICI开始后,心血管事件更频繁,可能是由于动脉样硬化加速.
- 患者需要优化心血管风险因素管理,提高对心血管风险的认识.
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