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严重与非严重的免疫检查点抑制剂诱导的心肌炎:当代1年结果

Osnat Itzhaki Ben Zadok^1,2, Amos Levi^2,3, Sanjay Divakaran¹

¹Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

JACC. CardioOncology

|January 11, 2024

概括

严重的免疫检查点抑制剂 (ICI) 心肌炎显著增加1年心血管死亡风险. 非严重的ICI心肌炎的结果与负面病例相似,这表明需要重新评估管理策略.

科学领域:

心脏瘤学 - 心脏瘤学
免疫学免疫学免疫学
临床医学临床医学

背景情况:

免疫检查点抑制剂 (ICI) 心肌炎患者的长期结果尚不清楚.
ICI心肌炎的临床严重程度谱需要进一步调查.

研究的目的:

调查严重和不严重ICI心肌炎患者的特征和心血管结果.
为了比较严重,不严重和阴性ICI心肌炎病例之间的结果.

主要方法:

对160名疑似ICI心肌炎患者 (2015-2022) 的回顾性队列研究.
根据国际心脏瘤学会的标准,分类为严重,不严重和负面的组.
评估1年心血管死亡率,全因死亡率,再入院,ICI恢复和左心室喷射分数.

主要成果:

严重的ICI心肌炎与更高的一年心血管死亡率 (29%对5%;HR:6.52;P<0.001) 有关.
非严重的ICI心肌炎显示心血管死亡率与负面病例相似 (HR:0.61).
全因死亡率,心血管再入院率和1年后的LVEF在各组之间是可比的.

结论:

严重的ICI心肌炎与1年心血管死亡率的增加有关,低于之前报告的水平.
不严重的ICI心肌炎患者的结果与没有心肌炎的患者相似.
对不严重的ICI心肌炎的管理策略需要重新评估.

关键词:

免疫检查点抑制剂免疫检查点抑制剂肌性心肌炎是一种心肌炎.预后预后预后严重的严重的严重.严重程度的严重程度.

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