用免疫检查点抑制剂治疗的晚期胸癌患者的潜在心血管事件
Anne-Claire Toublanc1, Maxime Faure2, Guillaume Verdy3
1Pulmonary Department, CIC1401, CHU Haut-Lévèque, Bordeaux, France.
概括
在晚期肺癌患者中,针对免疫相关心肌炎的系统查检测到1.68%的发病率,所有无症状. 这种方法还确定了其他心血管疾病,有助于在这个高风险人群中早期治疗.
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:
- 免疫相关心肌炎是一种罕见但严重的不良事件,与免疫检查点抑制剂 (ICI) 相关.
- 早期检测和管理对于改善患者的治疗结果至关重要.
- 接受ICI的晚期肺癌患者代表了患有心血管并发症风险的人群.
研究的目的:
- 预期评估ICI治疗的晚期肺癌患者免疫诱导心肌炎的发生率.
- 评估系统性形查对心肌炎和其他主要心血管不良事件 (MACE) 的早期检测的影响.
- 研究免疫诱导心肌炎的临床特征和结果.
主要方法:
- 一项前性双中心研究包括298名接受ICI治疗的成人患者,这些患者患有晚期肺癌.
- 进行了基线心脏生物标志物,心电图和胸前心脏回声学.
- 心肌炎的诊断遵循欧洲心脏病学会的指导方针;记录了MACE.
主要成果:
- 确诊了5例 (1.68%) 免疫诱导心肌炎,所有病例无症状,通过托罗邦素升高检测到.
- 没有直接归因于心肌炎的死亡;治疗涉及皮质类固醇和ICI中止.
- 在ICI治疗期间,系统查还检测到14种其他心血管疾病和11种MACE.
结论:
- 系统性心血管查发现亚临床免疫诱导心肌炎的发病率略高于之前报告的.
- 查没有改变治疗策略,因为检测到的病例是无症状的.
- 这种查方法对于在接受ICI治疗晚期肺癌的患者中检测其他心血管疾病非常有价值.
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