Eur Heart J:接受免疫检查点抑制剂治疗的患者发生心脏病的风险

2020-12-12 MedSci原创 MedSci原创

在肺癌和恶性黑色素瘤患者中,接受ICI治疗的心脏事件发生率增加。

近日,血管领域权威杂志Eur Heart J上发表了一篇研究文章,该研究旨在评估接受免疫检查点抑制剂(ICI)治疗的肺癌或恶性黑色素瘤患者发生心脏事件的风险。

这项研究纳入了2011–2017年期间丹麦全国范围内连续发生的肺癌或恶性黑色素瘤患者。该研究主要的复合结局是心脏事件(心律不齐、心包或心肌炎、心力衰竭)或心血管死亡。研究人员估计了绝对风险,并在多变量Cox模型中分析了ICI与心脏事件之间的关联。

研究人员纳入了25573名肺癌患者,其中743例接受程序性细胞死亡1抑制剂(PD1i)治疗,其1年心脏事件的绝对风险为9.7%[95%置信区间(CI)为6.8-12.5]。在13568例恶性黑色素瘤患者中,有145例接受PD1i治疗,而212例接受了细胞毒性T淋巴细胞相关蛋白4抑制剂(CTLA-4i)治疗。他们的1年风险为6.6%(1.8-11.3)和7.5%(3.7-11.3)。与没有ICI治疗的患者相比,心脏事件的风险率更高。从第一次ICI给药的6个月内,肺癌患者的风险比为2.14(95%CI为1.50-3.05),给予PD1i和CTLA- 4i治疗的恶性黑色素瘤患者分别为 4.30 (1.38–13.42)和4.93 (2.45–9.94)。6个月后,肺癌患者的HRs为2.26(1.27–4.02),接受CTLA-4i治疗的恶性黑色素瘤患者HRs为3.48(1.91–6.35)。

由此可见,在肺癌和恶性黑色素瘤患者中,接受ICI治疗的心脏事件发生率增加。

原始出处:

Maria D’Souza,et al.The risk of cardiac events in patients receiving immune checkpoint inhibitors: a nationwide Danish study.European Heart Journal.2020.https://doi.org/10.1093/eurheartj/ehaa884

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    2021-05-21 jklm09
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    2020-12-14 zhaojie88
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    2020-12-14 slcumt
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    2020-12-12 ゼロから

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