Department of Cardiology, National Center for Global Health and Medicine.
Department of Radiation Physics and Technology, National Center for Global Health and Medicine.
Int Heart J. 2022;63(2):293-298. doi: 10.1536/ihj.21-657.
Immune checkpoint inhibitors (ICIs) are widely used in various types of cancers and patients. Recently, it has been reported that ICIs aggravate atherosclerosis. This study aimed to identify characteristics that are related to the progression of atherosclerosis.This study was conducted in a single medical center and included 32 patients who were grouped based on the presence of an immune-related adverse event (IRAE). There were 16 IRAE patients and 16 non-IRAE patients. Atherosclerosis was measured as the volume of calcified plaque at the aortic arch on a computed tomography (CT) scan. We measured the volume on CT at 3 time points as follows: before treatment, at ICI initiation, and after 180 days or more.After the first ICI administration, the IRAE group showed significant exacerbation of atherosclerosis compared to the non-IRAE group (P = 0.002). A high volume of plaque was observed in IRAE patients after ICI treatment as compared to before ICI administration (P = 0.058).ICIs tend to hasten atherosclerosis progression in IRAE patients, indicating that high-risk cardiovascular patients should be concerned about cardiovascular events. Moreover, this study suggests the possibility of predicting IRAEs based on the volume of calcified plaques.
免疫检查点抑制剂 (ICIs) 在各种癌症和患者中广泛应用。最近有报道称,ICIs 可加重动脉粥样硬化。本研究旨在确定与动脉粥样硬化进展相关的特征。
这项研究在一家医疗中心进行,共纳入 32 名患者,根据是否发生免疫相关不良事件 (irAE) 进行分组。其中,16 名患者发生 irAE,16 名患者未发生 irAE。通过计算机断层扫描 (CT) 测量主动脉弓处钙化斑块的体积来评估动脉粥样硬化。我们在 3 个时间点测量 CT 上的体积,分别为治疗前、ICI 起始时和 180 天或更久后。
在首次接受 ICI 治疗后,与非 irAE 组相比,irAE 组的动脉粥样硬化明显加重 (P = 0.002)。与 ICI 治疗前相比,irAE 患者在接受 ICI 治疗后出现了更高的斑块体积 (P = 0.058)。
ICI 似乎会加速 irAE 患者的动脉粥样硬化进展,提示应关注心血管事件风险较高的患者。此外,本研究提示,根据钙化斑块的体积,有可能预测 irAE。