PMID- 34196077
OWN - NLM
STAT- MEDLINE
DCOM- 20220331
LR  - 20220909
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 23
IP  - 10
DP  - 2021 Oct
TI  - Cardiotoxicity associated with immune checkpoint inhibitor therapy: a 
      meta-analysis.
PG  - 1739-1747
LID - 10.1002/ejhf.2289 [doi]
AB  - AIMS: This study aimed to estimate the incidence of cardiac immune-related 
      adverse events (irAEs) in patients treated with immune checkpoint inhibitors 
      (ICIs). METHODS AND RESULTS: First, we performed an ICI pharmacovigilance 
      analysis, finding 4.2% of cardiac disorders, including myocarditis, for 
      anti-CTLA-4, anti-PD-1, and anti-PD-L1 therapies. Patients treated with anti-PD-1 
      antibodies presented a greater number of cardiac adverse events (AEs) than those 
      treated with anti-CTLA-4 (69.4% vs. 20%). Then, we analysed the incidence and 
      characteristics of cardiac irAEs in 1265 papers published prior to 31 August 
      2020. Of the 4751 patients studied, 1.3% presented cardiac irAEs, with 
      myocarditis being the most frequent (50.8%); 15 patients died (24.6%) due to 
      cardiac irAEs. Finally, we conducted a meta-analysis to determine cardiac irAEs 
      in randomized clinical trials, identified through a systematic search from the 
      ClinicalTrials.gov database, finding an incidence of 3.1% for ICI monotherapies, 
      5.8% for dual ICI therapies, 3.7% (irAEs/AEs) for ICIs plus chemotherapy, and 
      cardiac AEs were reported in 2.5% of patients treated solely with chemotherapy. 
      CONCLUSIONS: Our study provides precise data for the incidence of cardiac irAEs 
      among patients using ICIs, where despite its low incidence, the high rate of 
      mortality is an important issue to consider. ICIs induce mainly myocarditis at 
      the first doses, and dual therapies seem to provoke higher rates of cardiac irAEs 
      than monotherapies or ICIs plus chemotherapy.
CI  - (c) 2021 European Society of Cardiology.
FAU - Rubio-Infante, Nestor
AU  - Rubio-Infante N
AD  - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Catedra de 
      Cardiologia y Medicina Vascular, Monterrey, Mexico.
FAU - Ramirez-Flores, Yoel A
AU  - Ramirez-Flores YA
AD  - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Catedra de 
      Cardiologia y Medicina Vascular, Monterrey, Mexico.
FAU - Castillo, Elena C
AU  - Castillo EC
AD  - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Catedra de 
      Cardiologia y Medicina Vascular, Monterrey, Mexico.
FAU - Lozano, Omar
AU  - Lozano O
AD  - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Catedra de 
      Cardiologia y Medicina Vascular, Monterrey, Mexico.
AD  - Tecnologico de Monterrey, Centro de Investigacion Biomedica, Hospital Zambrano 
      Hellion, TecSalud, San Pedro Garza Garcia, Mexico.
FAU - Garcia-Rivas, Gerardo
AU  - Garcia-Rivas G
AD  - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Catedra de 
      Cardiologia y Medicina Vascular, Monterrey, Mexico.
AD  - Tecnologico de Monterrey, Centro de Investigacion Biomedica, Hospital Zambrano 
      Hellion, TecSalud, San Pedro Garza Garcia, Mexico.
AD  - Tecnologico de Monterrey, Centro de Medicina Funcional, Hospital Zambrano 
      Hellion, TecSalud, San Pedro Garza Garcia, Mexico.
FAU - Torre-Amione, Guillermo
AU  - Torre-Amione G
AD  - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Catedra de 
      Cardiologia y Medicina Vascular, Monterrey, Mexico.
AD  - Tecnologico de Monterrey, Centro de Investigacion Biomedica, Hospital Zambrano 
      Hellion, TecSalud, San Pedro Garza Garcia, Mexico.
AD  - The Methodist Hospital, Cornell University, Houston, TX, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20210729
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
CIN - Eur J Heart Fail. 2021 Oct;23(10):1748-1749. PMID: 34383998
CIN - Eur J Heart Fail. 2022 Jun;24(6):1142-1143. PMID: 35278026
MH  - Cardiotoxicity/epidemiology/etiology
MH  - Databases, Factual
MH  - *Heart Failure/drug therapy
MH  - Humans
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - *Neoplasms/complications/drug therapy
MH  - Pharmacovigilance
OTO - NOTNLM
OT  - Adverse events
OT  - CTLA-4
OT  - Cardiotoxicity
OT  - Immune checkpoint inhibitors
OT  - Myocarditis
OT  - PD-1
EDAT- 2021/07/02 06:00
MHDA- 2022/04/01 06:00
CRDT- 2021/07/01 07:27
PHST- 2021/06/04 00:00 [revised]
PHST- 2021/02/10 00:00 [received]
PHST- 2021/06/27 00:00 [accepted]
PHST- 2021/07/02 06:00 [pubmed]
PHST- 2022/04/01 06:00 [medline]
PHST- 2021/07/01 07:27 [entrez]
AID - 10.1002/ejhf.2289 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2021 Oct;23(10):1739-1747. doi: 10.1002/ejhf.2289. Epub 2021 
      Jul 29.