Torrente María, Blanco Mariola, Franco Fabio, Garitaonaindia Yago, Calvo Virginia, Collazo-Lorduy Ana, Gutiérrez Lourdes, Sánchez Juan Cristóbal, González-Del-Alba Aranzazu, Hernández Roberto, Méndez Miriam, Cantos Blanca, Núñez Beatriz, Sousa Pedro A C, Provencio Mariano
Department of Medical Oncology, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
Faculty of Health Sciences, Francisco de Vitoria University, Madrid, Spain.
Front Cardiovasc Med. 2022 Dec 1;9:1062858. doi: 10.3389/fcvm.2022.1062858. eCollection 2022.
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. However, despite their excellent therapeutic effect, these medications typically result in a broad spectrum of toxicity reactions. Immune-related cardiotoxicity is uncommon but can be potentially fatal, and its true incidence is underestimated in clinical trials. The aim of this study is to assess the incidence and identify risk factors for developing a cardiac event in patients treated with ICIs.
We conducted a single-institution retrospective study, including patients treated with ICIs in our center. The main outcomes were cardiac events (CE) and cardiovascular death.
A total of 378 patients were analyzed. The incidence of CE was 16.7%, during a median follow-up of 50.5 months. The multivariable analysis showed that age, a history of arrhythmia or ischemic heart disease, and prior immune-related adverse events were significantly associated with CE.
CE during ICI treatment are more common than currently appreciated. A complete initial cardiovascular evaluation is recommended, especially in high-risk patients, being necessary a multidisciplinary approach of a specialized cardio-oncology team.
免疫检查点抑制剂（ICIs）彻底改变了癌症治疗方式。然而，尽管这些药物具有出色的治疗效果，但通常会引发广泛的毒性反应。免疫相关心脏毒性并不常见，但可能致命，且其真实发病率在临床试验中被低估。本研究的目的是评估接受ICIs治疗的患者发生心脏事件的发生率并确定相关危险因素。
我们开展了一项单机构回顾性研究，纳入在本中心接受ICIs治疗的患者。主要结局为心脏事件（CE）和心血管死亡。
共分析了378例患者。在中位随访50.5个月期间，CE的发生率为16.7%。多变量分析显示，年龄、心律失常或缺血性心脏病病史以及既往免疫相关不良事件与CE显著相关。
ICI治疗期间的CE比目前所认识到的更为常见。建议进行全面的初始心血管评估，尤其是对高危患者，专业心脏肿瘤学团队的多学科方法是必要的。
