Jacc: Cardiooncology最新文献

{"title":"Cardiovascular Considerations During Cancer Therapy","authors":"Darryl P. Leong MBBS, MPH, MBiostat, PhD ,&nbsp;Sarah Waliany MD, MS ,&nbsp;Husam Abdel-Qadir MD, PhD ,&nbsp;Katelyn M. Atkins MD, PhD ,&nbsp;Tomas G. Neilan MD, MPH ,&nbsp;Ninian N. Lang MB ChB, PhD ,&nbsp;Jennifer E. Liu MD ,&nbsp;Anne H. Blaes MD, MS ,&nbsp;Hira S. Mian MD ,&nbsp;Heather N. Moore PharmD, BCOP, CPP ,&nbsp;Ludhmila A. Hajjar MD ,&nbsp;Alicia K. Morgans MD, MPH ,&nbsp;Peter M. Ellis MBBS, MMed, PhD ,&nbsp;Susan Dent MD","doi":"10.1016/j.jaccao.2024.06.005","DOIUrl":"10.1016/j.jaccao.2024.06.005","url":null,"abstract":"<div><div>The administration of certain cancer therapies can be associated with the development of cardiovascular toxicity or complications. This spectrum of toxicities is broad and requires nuanced approaches for prevention, identification, and management. This expert panel summarizes the consensus of opinions of diverse health care professionals in several key areas: 1) cardioprotection involves strategies aimed at the primary prevention of cancer therapy–related cardiovascular toxicity; 2) surveillance entails monitoring for cancer therapy–related cardiovascular toxicity during cancer therapy; 3) permissive cardiotoxicity is the informed continuation of cancer therapy in the presence of cardiovascular toxicity, along with the implementation of mitigating cardiovascular treatments; and 4) special considerations include the invasive management of severe cardiovascular disease in patients receiving treatments for advanced cancer and the exploration of drug-drug interactions in cardio-oncology. In this expert panel, we also highlight gaps in evidence in an effort to continue to advance science in the cardiovascular care of our patients undergoing cancer therapy.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 815-834"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elucidating the Signal from the Noise","authors":"Florence K. Keane MD ,&nbsp;Tomas G. Neilan MD, MPH ,&nbsp;Rachel B. Jimenez MD","doi":"10.1016/j.jaccao.2024.10.007","DOIUrl":"10.1016/j.jaccao.2024.10.007","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 946-948"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality Imaging in the Diagnostic Work-Up of Patients With Cardiac Masses","authors":"Francesco Angeli MD ,&nbsp;Francesca Bodega MD ,&nbsp;Luca Bergamaschi MD ,&nbsp;Matteo Armillotta MD ,&nbsp;Sara Amicone MD ,&nbsp;Lisa Canton MD ,&nbsp;Damiano Fedele MD ,&nbsp;Nicole Suma MD ,&nbsp;Daniele Cavallo MD ,&nbsp;Alberto Foà MD, PhD ,&nbsp;Marta Belmonte MD ,&nbsp;Vincenzo Russo MD ,&nbsp;Domenico Attinà MD ,&nbsp;Fabio Niro MD ,&nbsp;Rachele Bonfiglioli MD ,&nbsp;Stefano Fanti MD ,&nbsp;Anna Giulia Pavon MD ,&nbsp;Marco Guglielmo MD ,&nbsp;Saima Mushtaq MD ,&nbsp;Maria Abbondanza Pantaleo MD ,&nbsp;Carmine Pizzi MD","doi":"10.1016/j.jaccao.2024.09.006","DOIUrl":"10.1016/j.jaccao.2024.09.006","url":null,"abstract":"<div><div>Cardiac masses encompass a diverse range of benign and malignant tumors as well as pseudotumors. Accurate histologic identification is essential for guiding appropriate treatment, yet the diagnostic process remains challenging. Although biopsy is traditionally the diagnostic gold standard, its invasive nature and associated risks limit its application. A noninvasive multimodality imaging approach has recently emerged as an alternative, but standardized protocols and supporting evidence are still lacking. Echocardiography is typically the initial imaging modality, with cardiac magnetic resonance recognized as the noninvasive diagnostic gold standard. Cardiac computed tomography provides complementary data to aid in diagnosis and management, while positron emission tomography serves as a third-level imaging option. This state-of-the-art review highlights the role of current multimodality imaging techniques in diagnosing and managing cardiac masses and explores future directions for their applications.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 847-862"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2i and Primary Prevention of Cancer Therapy–Related Cardiac Dysfunction in Patients With Diabetes","authors":"Ammar W. Bhatti DO ,&nbsp;Rushin Patel MD ,&nbsp;Sourbha S. Dani MD ,&nbsp;Sumanth Khadke MD ,&nbsp;Bhargav Makwana MD ,&nbsp;Candace Lessey MD ,&nbsp;Jui Shah MD ,&nbsp;Zaid Al-Husami MD ,&nbsp;Eric H. Yang MD ,&nbsp;Paaladinesh Thavendiranathan MD, SM ,&nbsp;Tomas G. Neilan MD ,&nbsp;Diego Sadler MD ,&nbsp;Richard K. Cheng MD, MSc ,&nbsp;Susan F. Dent MD ,&nbsp;Jennifer Liu MD ,&nbsp;Teresa Lopez-Fernandez MD ,&nbsp;Joerg Herrmann MD ,&nbsp;Marielle Scherrer-Crosbie MD, PhD ,&nbsp;Daniel J. Lenihan MD ,&nbsp;Salim S. Hayek MD ,&nbsp;Sarju Ganatra MD","doi":"10.1016/j.jaccao.2024.08.001","DOIUrl":"10.1016/j.jaccao.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Specific cancer treatments can lead to cancer therapy–related cardiac dysfunction (CTRCD). Sodium glucose cotransporter-2 inhibitors (SGLT2is) can potentially prevent these cardiotoxic effects.</div></div><div><h3>Objectives</h3><div>This study sought to determine whether SGLT2i use is associated with a lower incidence of CTRCD in patients with type 2 diabetes mellitus (T2DM) and cancer, exposed to potentially cardiotoxic antineoplastic agents, and without a prior documented history of cardiomyopathy or heart failure.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients aged ≥18 years within the TriNetX database with T2DM, cancer, exposure to cardiotoxic therapies, and no prior documented history of cardiomyopathy or heart failure. Patients were categorized by SGLT2i use. After propensity score matching, outcomes were compared over 12 months using Cox proportional HRs. Subgroup analyses focusing on different cancer therapy classes were performed.</div></div><div><h3>Results</h3><div>The study included 8,675 propensity-matched patients in each cohort (mean age = ∼65 years, 42% females, 71% White, ∼19% gastrointestinal malignancy, and ∼25% anthracyclines). Patients prescribed SGLT2is had a lower risk of developing CTRCD (HR: 0.76: 95% CI: 0.69-0.84). SGLT2is also reduced heart failure exacerbations (HR: 0.81; 95% CI: 0.72-0.90), all-cause mortality (HR: 0.67; 95% CI: 0.61-0.74), and all-cause hospitalizations/emergency department visits (HR: 0.93; 95% CI: 0.89-0.97). Subgroup analyses also demonstrated reduced CTRCD risk across various classes of cancer therapies in patients prescribed SGLT2is.</div></div><div><h3>Conclusions</h3><div>SGLT2i administration was associated with a significantly decreased risk of developing CTRCD in patients with T2DM and cancer.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 863-875"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Inspiration Breath Hold to Reduce Cardiovascular Disease Risk for Breast Radiotherapy","authors":"Shanshan Gao MD ,&nbsp;Jian Zhang MD ,&nbsp;Beina Hui MD ,&nbsp;Weibin Hu MD ,&nbsp;Yongkai Lu PhD","doi":"10.1016/j.jaccao.2024.08.009","DOIUrl":"10.1016/j.jaccao.2024.08.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Page 985"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11712011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident Myocardial Infarction, Heart Failure, and Oncologic Outcomes in Breast Cancer Survivors","authors":"Oscar Calvillo-Argüelles MD ,&nbsp;Paaladinesh Thavendiranathan MD, SM ,&nbsp;Yue Chen MScPH ,&nbsp;Jiming Fang PhD ,&nbsp;Peter C. Austin PhD ,&nbsp;Eitan Amir MD, PhD ,&nbsp;Douglas S. Lee MD, PhD ,&nbsp;Husam Abdel-Qadir MD, PhD","doi":"10.1016/j.jaccao.2024.08.008","DOIUrl":"10.1016/j.jaccao.2024.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is associated with higher rates of incident cancer. Data are scarce regarding the association of incident CVD with oncologic outcomes after a cancer diagnosis.</div></div><div><h3>Objectives</h3><div>This study sought to determine whether incident myocardial infarction (MI) or heart failure (HF) in breast cancer survivors is associated with oncologic outcomes.</div></div><div><h3>Methods</h3><div>This was a population-based cohort study in Ontario, Canada, using linked administrative data sets of women diagnosed with first breast cancer between April 1, 2007, and March 31, 2015. A landmark analysis was conducted of women alive 2 years after breast cancer diagnosis, aged ≥40 years, and with available staging data and without recurrent/distant disease or preceding CVD. The exposure was a composite of MI and/or HF after the landmark date. The outcomes were cancer mortality, new non-breast malignancy diagnosis, and new chemotherapy initiation. Multivariable cause-specific hazards regression was used to determine the association of incident MI/HF (time-varying exposure) with outcomes.</div></div><div><h3>Results</h3><div>A total of 30,694 women (median age of 60 years) were included, of whom 1,346 developed incident MI/HF at a median of 3.9 years after the landmark date. At 5 years, the cumulative incidence was 5.9% (95% CI: 5.6%-6.1%) for cancer death, 4.3% (95% CI: 4.1%-4.6%) for non-breast malignancy, and 25.7% (95% CI: 25.2%-26.2%) for new chemotherapy. Incident MI/HF was associated with a higher hazard of cancer death (HR: 3.94; 95% CI: 3.38-4.59), non-breast malignancy (HR: 1.39; 95% CI: 1.06-1.82), and new chemotherapy (HR: 1.25; 95% CI: 1.02-1.53).</div></div><div><h3>Conclusions</h3><div>Incident MI and/or HF after breast cancer treatment are associated with higher hazards of adverse oncologic outcomes, highlighting the need to prioritize care for these patients.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 893-903"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease With Hormone Therapy and Ovarian Suppression in Premenopausal Breast Cancer Survivors","authors":"Elizabeth J. Polter PhD ,&nbsp;Anna E. Prizment PhD ,&nbsp;Rob F. Walker MPH ,&nbsp;Zoe Ryan BS ,&nbsp;Wendy Wang PhD ,&nbsp;Anne H. Blaes MD ,&nbsp;Pamela L. Lutsey PhD","doi":"10.1016/j.jaccao.2024.08.006","DOIUrl":"10.1016/j.jaccao.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Hormone therapies, including aromatase inhibitors and tamoxifen, are used with ovarian suppression to improve outcomes in premenopausal patients with breast cancer. Cardiovascular impacts of these treatments among premenopausal women are unknown.</div></div><div><h3>Objectives</h3><div>The aim of this study was to test the hypothesis that the use of aromatase inhibitors in combination with ovarian suppression, relative to tamoxifen, is associated with greater incident cardiovascular disease (CVD) risk in premenopausal breast cancer survivors.</div></div><div><h3>Methods</h3><div>The MarketScan administrative claims databases (2013-2020) were used to identify enrollees younger than 55 years who had incident breast cancer and were treated with either an aromatase inhibitor and ovarian suppression or tamoxifen. Propensity score matching was used to balance treatment groups across confounding variables including age, breast cancer treatments, and comorbidities. The HR for CVD (including atrial fibrillation, myocardial infarction, stroke, heart failure hospitalization, angina, or coronary revascularization) was calculated by treatment group.</div></div><div><h3>Results</h3><div>In the matched cohort, over a median follow-up time of 1.55 years, the incidence rate was 2.3 per 100 person-years among users of aromatase inhibitors plus ovarian suppression (51 CVD events in 2,205 person-years) and 1.0 per 100 person-years for tamoxifen users (102 CVD events in 9,913 person-years). Users of aromatase inhibitors plus ovarian suppression had a 2.20-fold higher hazard of CVD than tamoxifen users (HR: 2.20; 95% CI: 1.57-3.09). In absolute terms, the incidence rate difference was 0.012 (95% CI: 0.006-0.019). Findings were robust to several sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Premenopausal patients with breast cancer treated with aromatase inhibitors and ovarian suppression may be at elevated risk for CVD and should be monitored for cardiovascular risk.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 907-918"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Calcium Scores After Prophylactic Premenopausal Bilateral Salpingo-Oophorectomy","authors":"Maarten J. Beekman MD ,&nbsp;Lara Terra MD ,&nbsp;Bernadette A.M. Heemskerk-Gerritsen PhD ,&nbsp;Carlijn M. van der Aalst PhD ,&nbsp;Jeanine E. Roeters van Lennep MD, PhD ,&nbsp;Marc van Beurden MD, PhD ,&nbsp;Helena C. van Doorn MD, PhD ,&nbsp;Joanne A. de Hullu MD, PhD ,&nbsp;Eleonora B.L. van Dorst MD ,&nbsp;Constantijne H. Mom MD, PhD ,&nbsp;Marian J.E. Mourits MD, PhD ,&nbsp;Brigitte F.M. Slangen MD, PhD ,&nbsp;Annemarieke Bartels-Rutten MD, PhD ,&nbsp;Ricardo P.J. Budde MD, PhD ,&nbsp;Miranda M. Snoeren MD ,&nbsp;Tim Leiner MD, PhD ,&nbsp;Pim A. de Jong MD, PhD ,&nbsp;Rozemarijn Vliegenthart MD, PhD ,&nbsp;R. Nils Planken MD, PhD ,&nbsp;Casper Mihl MD, PhD ,&nbsp;Flora E. van Leeuwen PhD","doi":"10.1016/j.jaccao.2024.09.011","DOIUrl":"10.1016/j.jaccao.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at high familial risk of ovarian cancer leads to immediate menopause. Although early natural menopause is associated with increased cardiovascular disease risk, evidence on long-term cardiovascular disease risk after early surgical menopause is scarce.</div></div><div><h3>Objectives</h3><div>We sought to determine the long-term influence of the timing of RRSO on the development of coronary artery calcium (CAC), an established marker for cardiovascular disease risk.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study (N = 733) nested in a nationwide cohort of women at high familial risk of ovarian cancer. In women aged 60-70 years (n = 328), we compared CAC scores between women with a premenopausal RRSO (age ≤45 years) and women with a postmenopausal RRSO (age ≥54 years), using multivariable Poisson analyses. Within the premenopausal RRSO group (n = 498), we also examined the effect of age at RRSO. In addition, we compared the premenopausal RRSO group with an external reference cohort (n = 5,226).</div></div><div><h3>Results</h3><div>Multivariable analyses showed that the prevalence rates of any CAC (CAC &gt;0), at least moderate CAC (CAC &gt;100), and severe CAC (CAC &gt;400) were comparable between the premenopausal and postmenopausal RRSO groups (relative risk [RR]: 0.93; 95% CI: 0.75-1.15 for any CAC; RR: 0.71; 95% CI: 0.43-1.17 for at least moderate CAC; RR: 0.81; 95% CI: 0.30-2.13 for severe CAC). There was no difference in CAC between the premenopausal RRSO group and a similar aged reference cohort. Timing of premenopausal RRSO (early premenopausal RRSO [&lt;41 years] vs late premenopausal RRSO [41-45 years]) did not affect the outcomes.</div></div><div><h3>Conclusions</h3><div>Our results do not show a long-term adverse effect of surgical menopause on the development of CAC.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 922-931"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors","authors":"Florian Moik MD, PhD ,&nbsp;Jakob M. Riedl MD, PhD ,&nbsp;Dominik Barth MD, PhD ,&nbsp;Franziska Berton ,&nbsp;Michael Fink ,&nbsp;Cornelia Englisch MD ,&nbsp;Christoph Hoeller MD ,&nbsp;Thorsten Fuereder MD ,&nbsp;Leyla Ay MD ,&nbsp;Ingrid Pabinger MD ,&nbsp;Erika Richtig MD ,&nbsp;Nikolaus John MD ,&nbsp;Sarah M. Kostmann BSc, MSc, MSc ,&nbsp;Philipp J. Jost MD ,&nbsp;Armin Gerger MD ,&nbsp;Angelika Terbuch MD ,&nbsp;Matthias Preusser MD ,&nbsp;Cihan Ay MD","doi":"10.1016/j.jaccao.2024.09.007","DOIUrl":"10.1016/j.jaccao.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cancer treated with immune-checkpoint inhibitors (ICIs) have a substantial risk of venous thromboembolism (VTE). The association between ICI-induced inflammation and hypercoagulability is unclear, and no biomarkers currently exist to stratify VTE risk.</div></div><div><h3>Objectives</h3><div>The authors sought to determine the association between the early changes in C-reactive protein (CRP) after ICI initiation and the risk of VTE.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with cancer initiating ICI therapy from 2 academic cancer centers, serving as discovery and external validation cohorts. Patients were stratified based on CRP trajectories during the first 3 months of ICI treatment, with a CRP rise defined as a 2-fold increase from baseline. Patients were followed for VTE for the duration of ICI therapy, and competing risk and time-dependent analyses were used.</div></div><div><h3>Results</h3><div>A total of 822 patients were included. In the discovery cohort (n = 405), the cumulative VTE incidence in patients with a CRP rise (n = 159, 39.3%) was 19.9% (95% CI: 8.4%-34.8%), compared with 8.6% (3.1%-17.6%) in those without a CRP rise. After adjusting for key patient- and cancer-specific confounders, the subdistribution HR for VTE in patients with a CRP rise was 2.64 (95% CI: 1.06-6.62). This was confirmed in the external validation cohort (n = 417; subdistribution HR: 2.25; 95% CI: 1.03-4.94), with VTE incidences of 22.9% (95% CI: 9.7%-39.3%) in patients with a CRP rise and 10.8% (95% CI: 7.4%-15.1%) in those without. The association between CRP rise and VTE risk was confirmed in a time-dependent analysis and was consistent after adjusting for disease progression as a potential time-dependent confounder.</div></div><div><h3>Conclusions</h3><div>Early CRP changes during ICI therapy are associated with an increased risk of VTE, suggesting a potential association between ICI-induced inflammation and hypercoagulability. CRP trajectories may serve as a biomarker for ICI-associated VTE.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 965-975"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal Therapy and Cardiovascular Health","authors":"Farzin Khosrow-Khavar PhD ,&nbsp;Laurent Azoulay PhD","doi":"10.1016/j.jaccao.2024.10.009","DOIUrl":"10.1016/j.jaccao.2024.10.009","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 6","pages":"Pages 919-921"},"PeriodicalIF":12.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11712015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}