用免疫检查点抑制剂治疗癌症患者的心血管毒性:使用比利时医院数据的自然语言处理进行的多中心研究
D Delombaerde1,2, C L Oeste3, V Geldhof4
1Integrated Cancer Canter Ghent, Department of Medical Oncology, General Hospital AZ Maria Middelares, Ghent, Belgium.
概括
心血管不良事件 (CV AEs) 发生在12.5%的癌症患者中,这些患者接受了免疫检查点抑制剂 (ICI) 治疗. 这些CVAE,包括心力衰竭和心房动,可以在ICI治疗期间或之后的不同时间表现出来.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药物监督 药物监督 药物监督
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 心血管 (CV) 的不良事件 (AE) 是已知的ICI治疗的并发症.
- 在现实环境中,这些CV AEs的确切发生率和时间尚未得到充分确定.
研究的目的:
- 确定接受ICI的癌症患者中各种CVAE的患病率和发病率.
- 分析ICI启动后各种CV AEs的发病时间.
- 使用现实世界的数据来描述CV事件模式.
主要方法:
- 从三个比利时医院使用电子健康记录 (EHR) (2017年3月至2022年8月).
- 将EHR数据处理成观察医疗结果伙伴关系共同数据模型.
- 通过自然语言处理 (NLP) 丰富结构化EHR数据,用于非结构化数据分析以识别和验证CV事件.
主要成果:
- 包括1571名癌症患者 (平均年龄67岁);12.5%的人经历了心血管事件.
- 常见的心血管不良事件:心力衰竭 (5.3%),心房动 (4.6%),心肌梗塞 (2.0%),心肌炎 (1.2%).
- 发病的中位时间各不相同,心肌炎最早出现 (109天),Takotsubo心肌病最晚出现 (529天).
结论:
- 这项研究提供了使用NLP处理的EHRs首次描述CV事件频率和发病时间.
- 现实世界CV AE频率与其他研究相比,但显示出晚期发病.
- 临床医生必须意识到CVAE在ICI治疗期间或之后随时可能发生,并且呈现不同.
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