دورية أكاديمية
Pre-Existing Autoimmune Disease Increases the Risk of Cardiovascular and Noncardiovascular Events After Immunotherapy.
العنوان: | Pre-Existing Autoimmune Disease Increases the Risk of Cardiovascular and Noncardiovascular Events After Immunotherapy. |
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المؤلفون: | Lee C; Division of Cardiology, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA., Drobni ZD; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.; Heart and Vascular Center, Semmelweis University, Budapest, Hungary., Zafar A; Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA., Gongora CA; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Zlotoff DA; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Alvi RM; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Taron J; Department of Radiology, University Hospital Freiburg, Freiburg, Germany., Rambarat PK; Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Schoenfeld S; Division of Rheumatology, Massachusetts General Hospital, Boston, Massachusetts, USA., Mosarla RC; Division of Cardiology, New York University, New York, New York, USA., Raghu VK; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Hartmann SE; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Gilman HK; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Murphy SP; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Sullivan RJ; Division of Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Faje A; Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Hoffmann U; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Zhang L; Department of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA., Mayrhofer T; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Reynolds KL; Division of Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Neilan TG; Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.; Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. |
المصدر: | JACC. CardioOncology [JACC CardioOncol] 2022 Dec 20; Vol. 4 (5), pp. 660-669. Date of Electronic Publication: 2022 Dec 20 (Print Publication: 2022). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101761697 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-0873 (Electronic) Linking ISSN: 26660873 NLM ISO Abbreviation: JACC CardioOncol Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: [New York] : Elsevier Inc., [2019]- |
مستخلص: | Background: The use of immune checkpoint inhibitors (ICI) is associated with cardiovascular (CV) events, and patients with pre-existing autoimmune disease are at increased CV risk. Objectives: The aim of this study was to characterize the risk for CV events in patients with pre-existing autoimmune disease post-ICI. Methods: This was a retrospective study of 6,683 patients treated with ICIs within an academic network. Autoimmune disease prior to ICI was confirmed by chart review. Baseline characteristics and risk for CV and non-CV immune-related adverse events were compared with a matched control group (1:1 ratio) of ICI patients without autoimmune disease. Matching was based on age, sex, history of coronary artery disease, history of heart failure, and diabetes mellitus. CV events were a composite of myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, stroke, transient ischemic attack, deep venous thrombosis, pulmonary embolism, or myocarditis. Univariable and multivariable Cox proportional hazards models were used to determine the association between autoimmune disease and CV events. Results: Among 502 patients treated with ICIs, 251 patients with and 251 patients without autoimmune disease were studied. During a median follow-up period of 205 days, there were 45 CV events among patients with autoimmune disease and 22 CV events among control subjects (adjusted HR: 1.77; 95% CI: 1.04-3.03; P = 0.0364). Of the non-CV immune-related adverse events, there were increased rates of psoriasis (11.2% vs 0.4%; P < 0.001) and colitis (24.3% vs 16.7%; P = 0.045) in patients with autoimmune disease. Conclusions: Patients with autoimmune disease have an increased risk for CV and non-CV events post-ICI. Competing Interests: Dr Neilan is supported by gifts from A. Curt Greer and Pamela Kohlberg and from Christina and Paul Kazilionis, the Michael and Kathryn Park Endowed Chair in Cardiology, and a Hassenfeld Scholar Award; and is supported by grants from the National Institute of Health/National Heart, Lung, and Blood Institute (R01HL30539, RO1HL137562, and K24HL150238). Dr Drobni was supported by the ÚNKP-22-4-II-SE New National Excellence Program of the Ministry for Innovation and Technology from the National Research, Development, and Innovation fund. Dr Neilan has been a consultant to and received fees from H3-Biomedicine, Abbvie, Roche, C-4 Therapeutics, Sanofi, CRO Oncology, Genentech, and Amgen, outside of the current work; has received consulting fees from Bristol Myers Squibb for advice focused on myocarditis related to ICIs; and has received grant funding from AstraZeneca and Bristol Myers Squibb. Dr Taron has received funding from Deutsche Forschungsgesellschaft (TA 1438/1-2.T); and is a member of the Speakers Bureaus of Siemens Healthineers and Bayer, unrelated to this work. Dr Hoffmann has received consulting fees from Abbott, Duke University (National Institutes of Health), and Recor Medical, outside the submitted work; and has received research grants from Medimmune, HeartFlow, AstraZeneca, and KOWA. Dr Sullivan has been a consultant to Asana, AstraZeneca, Bristol Myers Squibb, Eisai, Iovance, Merck, Novartis, Pfizer, OncoSec, and Replimune; and has received research funding from Amgen and Merck, all outside the present work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (© 2022 The Authors.) |
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معلومات مُعتمدة: | K24 HL150238 United States HL NHLBI NIH HHS |
فهرسة مساهمة: | Keywords: CABG, coronary artery bypass graft; CTLA-4, cytotoxic T lymphocyte–associated antigen-4; CV, cardiovascular; DVT, deep venous thrombosis; ICI, immune checkpoint inhibitor; MI, myocardial infarction; PCI, percutaneous coronary intervention; PD-1, programmed death-1; PD-L1, programmed death-ligand 1; PE, pulmonary embolism; SMD, standardized mean difference; TIA, transient ischemic attack; coronary artery disease; immunotherapy; irAE, immune-related adverse event; myocarditis; thrombosis |
تواريخ الأحداث: | Date Created: 20230113 Latest Revision: 20231108 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC9830202 |
DOI: | 10.1016/j.jaccao.2022.11.008 |
PMID: | 36636443 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2666-0873 |
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DOI: | 10.1016/j.jaccao.2022.11.008 |