用免疫检查点抑制剂治疗的肺癌患者的心血管不良事件:全国数据库研究
Tsuyoshi Isawa1, Shintaro Togashi2,3, Masataka Taguri4
1Department of Cardiology, Sendai Kousei Hospital, Sendai 981-0914, Japan.
The oncologist
|June 23, 2025
概括
免疫检查点抑制剂 (ICI) 在肺癌患者中增加主要心血管不良事件 (MACE),主要是由于心肌炎和心周炎. 以前的心力衰竭和慢性功能衰竭是MACE的关键危险因素.
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) 在癌症治疗中至关重要.
- 需要进行大型队列研究,以了解与ICI相关的心血管风险.
- 主要不良心血管事件 (MACE) 是ICI治疗的患者的一个担忧.
研究的目的:
- 在接受ICI治疗的初级肺癌患者中比较MACE发病率与非ICI化疗.
- 在接受ICI的患者中识别MACE的风险因素.
主要方法:
- 一个全国性的日本数据库的回顾性分析.
- 在每个队列中的743名患者的倾向性得分匹配 (ICI与非ICI化疗).
- 结果在180天内进行评估.
主要成果:
- 治疗ICI与MACE的发生率显著高 (4.0%与非ICI组相比,HR1.98,P=.030).
- 在ICI组中,心肌炎和心周炎的频率显著增加 (P=.048).
- 慢性功能衰竭 (HR 2.16) 和先前心力衰竭 (HR 3.08) 是ICI治疗患者中MACE的显著风险因素.
结论:
- 在肺癌患者中,ICI治疗增加了MACE风险,主要是由于心肌炎和心周炎.
- 以前的心力衰竭和慢性功能衰竭是MACEs在这个人群中的重要危险因素.
- 这些发现凸显了接受ICI的患者心血管监测的必要性.
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