Cardiovascular events after the initiation of immune checkpoint inhibitors

被引:7
|
作者
Suzuki, Yuta [1 ,2 ]
Kaneko, Hidehiro [1 ,3 ,9 ]
Tamura, Yuichi [4 ]
Okada, Akira [5 ]
Fujiu, Katsuhito [1 ,3 ]
Michihata, Nobuaki [6 ]
Takeda, Norifumi [1 ]
Jo, Taisuke [6 ]
Morita, Hiroyuki [1 ]
Node, Koichi [7 ]
Yasunaga, Hideo [8 ]
Komuro, Issei [1 ]
机构
[1] Univ Tokyo, Dept Cardiovasc Med, Tokyo, Japan
[2] Natl Inst Publ Hlth, Ctr Outcomes Res & Econ Evaluat Hlth, Saitama, Japan
[3] Univ Tokyo, Dept Adv Cardiol, Tokyo, Japan
[4] Int Univ Hlth & Welf, Sch Med, Dept Cardiol, Narita, Japan
[5] Univ Tokyo, Grad Sch Med, Dept Prevent Diabet & Lifestyle Related Dis, Tokyo, Japan
[6] Univ Tokyo, Dept Hlth Serv Res, Tokyo, Japan
[7] Saga Univ, Dept Cardiovasc Med, Saga, Japan
[8] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Tokyo, Japan
[9] Univ Tokyo, Dept Cardiovasc Med, 7-3-1 Hongo, Bunkyo Ku, Tokyo 1138655, Japan
关键词
Cancer; Immune checkpoint inhibitors; Immune -related adverse events; Cardiovascular disease; MYOCARDITIS;
D O I
10.1016/j.heliyon.2023.e16373
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
We sought to clarify the incidence of major adverse cardiac events (MACE) after the initiation of immune checkpoint inhibitors (ICIs). We analyzed the JMDC Claims Database between 2005 and 2021. The study included 2972 patients with no history of cardiovascular disease and a pre-scription for an ICI. The primary outcome was the incidence of MACE, including myocarditis, pericarditis, Takotsubo cardiomyopathy, atrio-ventricular block, heart failure, myocardial infarction, and stroke. The median age of study participants was 59 (Q1-Q3 53-65) years, and 2163 participants (72.8%) were male. Lung cancer was the most common cancer site (n = 1603). Among ICIs, programmed cell death-1 (PD-1) was most frequently used, and a combination ICI treatment was conducted in 110 patients (3.7%). During a mean follow-up of 358 & PLUSMN; 327 days, 419 MACE events were recorded. The incidence rate of myocarditis, pericarditis, Takotsubo cardiomyopathy, atrio-ventricular block, heart failure, myocardial infarction, and stroke was 3.4, 142.3, 10.3, 17.2, 1191.2, 55.2, and 278.5 per 10,000 person-years, respectively. The incidence of cardiovascular events was higher within 180 days after the initial prescription of ICI. The continuation rate of ICI after MACE was 38.4%. In conclusion, our analysis of a nationwide epidemiological dataset demonstrated the incidence of MACE after the initiation of ICI treatment. The incidence of heart failure was higher than expected, and the continuation rate of ICI treat-ment after MACE was low. Our results indicated the importance of monitoring and prevention of cardiovascular events in cancer patients requiring ICI treatment.
引用
收藏
页数:8
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