与免疫检查点抑制剂相关的心血管不良事件:一项回顾性多中心队列研究
Yi Zheng1, Ziliang Chen1, Wenhua Song1
1Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
Cancer medicine
|May 16, 2024
概括
免疫检查点抑制剂 (ICI) 可以引起心肌炎. 较高的肌酸激酶-MB (CK-MB) 预测了ICI相关的心肌炎,而心脏中高素-I (cTnI) 和中性粒细胞与淋巴细胞的比率 (NLR) 预测了严重的病例.
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) 已经彻底改变了癌症治疗.
- 心血管毒性,特别是心肌炎,是与ICI相关的严重不良事件.
- 虽然ICI相关心肌炎并不常见,但死亡率很高.
研究的目的:
- 研究接受ICI的患者心血管不良事件的风险因素和预测生物标志物.
- 鉴定ICI相关心肌炎的特征,并确定严重疾病的预测因素.
主要方法:
- 进行了一项多中心的回顾性研究.
- 后勤回归分析了心肌炎和严重心肌炎的风险因素.
- 接收器操作特征 (ROC) 曲线评估了心脏生物标志物的诊断效用.
主要成果:
- 在44名患者中,有35名患有心肌炎.
- 肌肉性心脏炎患者表现出较高的心脏类素-I (cTnI),肌酸酶 (CK) 和肌酸酶-MB (CK-MB) 的水平.
- 升高的CK-MB是心肌炎的独立风险因素;升高的cTnI和中性粒细胞与淋巴细胞的比率 (NLR) 预测了严重的心肌炎.
结论:
- CK-MB是ICI相关心肌炎的关键预测因子.
- cTnI和NLR是识别严重ICI相关心肌炎的有价值生物标志物.
- 在预测和识别ICI诱导的心血管毒性方面,CK-MB,cTnI和NLR显示出前景.
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