在开始免疫检查点抑制剂后发生的心血管事件
Yuta Suzuki1,2, Hidehiro Kaneko1,3, Yuichi Tamura4
1The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
免疫检查点抑制剂 (ICI) 可以导致主要心脏不良事件 (MACE),包括心力衰竭,特别是在治疗开始后的180天内. 对接受ICI治疗的癌症患者来说,心血管监测至关重要.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 心血管不良事件是已知但尚未完全描述的ICI治疗并发症.
- 了解重大心脏不良事件 (MACE) 的发生率对于患者安全至关重要.
研究的目的:
- 为了确定ICI治疗开始后的MACE发生率.
- 为了确定与ICI使用相关的特定心血管事件.
- 分析MACE后ICI治疗的时间和持续率.
主要方法:
- 对JMDC索赔数据库 (2005-2021) 的分析.
- 包括2972名没有先前心血管疾病的患者接受ICI.
- 主要结局:MACE的发病率 (心肌炎,心周炎,Takotsubo心肌病,心房阻塞,心力衰竭,心肌梗塞,中风).
主要成果:
- 记录了MACE的整体发病率.
- 具体事件发生率每1万人年包括心力衰竭 (1191.2),中风 (278.5) 和心肌梗塞 (55.2).
- 心血管事件发生在ICI开始后的180天内更频繁;ICI在MACE后的延续率为38.4%.
结论:
- ICI治疗与MACE的显著发病率有关,心力衰竭发生的频率高于预期.
- MACE的时间表明需要在ICI治疗的早期进行警的心血管监测.
- 低的ICI延续率在MACE后强调了潜在的治疗修改和癌症患者主动心血管风险管理的重要性.
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