Frontiers in Cardiovascular Medicine (Dec 2022)

Assessing the risk of cardiovascular events in patients receiving immune checkpoint inhibitors

  • María Torrente,
  • María Torrente,
  • Mariola Blanco,
  • Fabio Franco,
  • Yago Garitaonaindia,
  • Virginia Calvo,
  • Ana Collazo-Lorduy,
  • Lourdes Gutiérrez,
  • Juan Cristóbal Sánchez,
  • Aranzazu González-del-Alba,
  • Roberto Hernández,
  • Miriam Méndez,
  • Blanca Cantos,
  • Beatriz Núñez,
  • Pedro A. C. Sousa,
  • Mariano Provencio

DOI
https://doi.org/10.3389/fcvm.2022.1062858
Journal volume & issue
Vol. 9

Abstract

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BackgroundImmune 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.MethodsWe conducted a single-institution retrospective study, including patients treated with ICIs in our center. The main outcomes were cardiac events (CE) and cardiovascular death.ResultsA 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.ConclusionCE 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.

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