BRAF/MEK抑制的心脏毒性作用:一项观察性研究
Jannek Brauer1, Daniel Scheidet2, Sebastian Romann1
1University Hospital Heidelberg, Department of Cardiology, Heidelberg, Germany; German Center of Cardiovascular Research (DZHK), partner site Heidelberg/Mannheim, Germany.
概括
与癌症治疗有关的心脏功能障碍 (CTRCD) 影响了44%的接受BRAF/MEK抑制剂的患者. 冠状动脉疾病是关键的风险因素,突出了癌症治疗期间需要动态心脏监测的需要.
科学领域:
- 心脏瘤学是一门专业.
- 在瘤学瘤学.
- 心血管医学 心血管医学
背景情况:
- BRAF/MEK抑制剂对于BRAF突变癌症至关重要.
- 这些抑制剂的心血管副作用还没有得到很好的定义.
- 使用现代定义,关于癌症治疗相关心脏功能障碍 (CTRCD) 的数据有限.
研究的目的:
- 在接受BRAF/MEK抑制剂的患者中确定CTRCD的发病率和危险因素.
- 使用国际心脏瘤学会 (ICOS) 的标准,包括成像和生物标志物.
- 使用当代的,全面的定义来评估CTRCD.
主要方法:
- 对75名接受BRAF/MEK抑制剂治疗的患者进行前性监测.
- 在基线和随访时进行心声回声 (包括GLS),hs-cTnT和NT-proBNP评估.
- 根据ICOS标准对CTRCD的分类;根据ESC类别进行基线风险分层.
主要成果:
- 在44%的患者中发生了CTRCD (轻度17%,中度23%,重度4%).
- 冠状动脉疾病是唯一重要的基线预测因子 (OR 11.0,p=0.029).
- 传统的风险因素和基线生物标志物 (hs-cTnT,NT-proBNP,LVEF) 不具有预测性.
结论:
- 在接受BRAF/MEK抑制剂的患者中,CTRCD很常见.
- 冠状动脉疾病是CTRCD的重要风险标志物.
- 动态监测策略对于管理这些患者心脏毒性至关重要.
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