免疫疗法和心脏:了解免疫检查点抑制剂的心血管风险
Maria Sol Andres1, Maria Clara Llamedo1, Sivatharshini Ramalingam1
1Cardio-Oncology Centre of Excellence, Royal Brompton Hospital, London, UK.
Presse medicale (Paris, France : 1983)
|November 23, 2025
概括
免疫检查点抑制剂 (ICI) 改善癌症存活率,但可能导致心血管不良事件. 虽然ICI相关心肌炎的死亡率有所下降,但现在已经认识到更广泛的心血管问题.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗,在各种恶性瘤中提高了患者的生存率.
- 然而,ICI可以引发与免疫相关的不良事件 (irAEs),特别是严重的心血管并发症.
- 最初罕见且致命的ICI相关心肌炎,由于提高认识和改善治疗方法,死亡率有所降低.
研究的目的:
- 审查与ICI相关的心血管不良影响的当前理解.
- 讨论ICI介导的心血管不良事件 (CVAE) 的不断扩大的范围.
- 突出诊断挑战,治疗策略和ICI相关CVAE的未来研究方向.
主要方法:
- 对ICI相关心血管不良事件研究的文献综述.
- 分析ICI媒介性心肌炎和其他CVAE的发病率,死亡率和临床表现.
- 综合当前的诊断和治疗方法.
主要成果:
- 与ICI相关的心肌炎,曾经被认为是罕见的,死亡率高,现在死亡率明显降低.
- CVAE的范围超越心肌炎,包括心周炎,左心室功能障碍,急性冠状动脉综合征和心律不整.
- 早期检测和不断发展的治疗策略改善了ICI相关CVAE患者的治疗结果.
结论:
- 心血管不良事件是接受ICI的患者的一个重大问题.
- 对各种CVAE及其管理的全面理解对于优化癌症治疗至关重要.
- 需要进一步的研究来完善ICI介导的心血管毒性诊断工具和治疗干预措施.
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