Muraoka Nao, Oyakawa Takuya, Fujita Ayano, Iida Kei, Yokota Tomoya, Kenmotsu Hirotsugu
Division of Cardio-oncology, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Internal Medicine, Mishima Tokai Hospital, Shizuoka, Japan.
Asia Pac J Oncol Nurs. 2024 Nov 19;12:100624. doi: 10.1016/j.apjon.2024.100624. eCollection 2025 Dec.
To investigate the incidence and characteristics of ischemic cardiac events, specifically major adverse cardiac events (MACE), in patients undergoing long-term treatment with multikinase inhibitors (MKIs) such as lenvatinib and sorafenib.
A single-center retrospective analysis was conducted on 41 patients treated with lenvatinib or sorafenib for more than one year at our institution from 2015 to 2022. Patient records were reviewed to collect data on demographics, cancer type, cardiovascular risk factors, MKI treatment duration, and MACE incidence. MACE events, defined as acute heart failure, fatal arrhythmia, acute myocardial infarction, and coronary revascularization, were analyzed to determine potential correlations with MKI therapy.
Among the 41 patients, three (7.3%) developed MACE, presenting as acute heart failure, fatal arrhythmia, and acute myocardial infarction, all associated with significant coronary artery stenosis. Notably, none of these patients had a prior history of cardiovascular disease. Despite variations in clinical presentation, all cases suggested a link between long-term MKI administration and accelerated coronary atherosclerosis. Factors involved in atherosclerosis were significantly older and tended to be more hypertensive in the non-MACE group.
Long-term MKI therapy may increase the risk of severe ischemic cardiac events, likely due to accelerated atherosclerosis. Clinicians and oncology nurses should monitor patients closely for early signs of angina, especially in an outpatient setting, to prevent acute cardiac events. Further large-scale studies are warranted to establish a clearer causal relationship between MKI therapy and cardiovascular risks.
研究接受乐伐替尼和索拉非尼等多激酶抑制剂（MKIs）长期治疗的患者缺血性心脏事件的发生率和特征，特别是主要不良心脏事件（MACE）。
对2015年至2022年在我院接受乐伐替尼或索拉非尼治疗超过一年的41例患者进行单中心回顾性分析。查阅患者记录以收集人口统计学、癌症类型、心血管危险因素、MKI治疗持续时间和MACE发生率的数据。分析定义为急性心力衰竭、致命性心律失常、急性心肌梗死和冠状动脉血运重建的MACE事件，以确定与MKI治疗的潜在相关性。
在41例患者中，3例（7.3%）发生MACE，表现为急性心力衰竭、致命性心律失常和急性心肌梗死，均与严重冠状动脉狭窄有关。值得注意的是，这些患者均无心血管疾病病史。尽管临床表现存在差异，但所有病例均提示长期服用MKI与加速冠状动脉粥样硬化之间存在关联。非MACE组中涉及动脉粥样硬化的因素年龄明显更大，且往往高血压程度更高。
长期MKI治疗可能会增加严重缺血性心脏事件的风险，可能是由于动脉粥样硬化加速所致。临床医生和肿瘤护士应密切监测患者心绞痛的早期迹象，尤其是在门诊环境中，以预防急性心脏事件。有必要进行进一步的大规模研究，以明确MKI治疗与心血管风险之间更清晰的因果关系。
