Jacc: Cardiooncology最新文献

{"title":"Immune Checkpoint Inhibitor–Related Myocarditis With or Without Concomitant Myopathy","authors":"Osnat Itzhaki Ben Zadok MD, MSc ,&nbsp;Meabh J. O’Hare MBBCH ,&nbsp;Anju Nohria MD, MSc","doi":"10.1016/j.jaccao.2025.02.005","DOIUrl":"10.1016/j.jaccao.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Data on cardiovascular outcomes in patients with both immune checkpoint inhibitor–induced immune-related myocarditis (irMyocarditis) and immune-related myopathy (irMyopathy) are limited.</div></div><div><h3>Objectives</h3><div>The aim of this study was to describe clinical characteristics and cardiovascular outcomes in patients with isolated irMyocarditis vs those with concomitant irMyocarditis and irMyopathy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted among patients diagnosed with irMyocarditis at Massachusetts General Brigham between 2015 and 2023. Clinical, laboratory, and imaging characteristics were evaluated, and cardiovascular outcomes were compared between patients with and those without concomitant irMyopathy. The outcomes assessed included acute heart failure requiring diuresis, significant arrhythmias (ventricular arrhythmias and high-degree atrioventricular block), and cardiovascular and all-cause mortality during the index hospitalization.</div></div><div><h3>Results</h3><div>Among 101 patients with irMyocarditis, 32 (31.7%) had concomitant irMyopathy. Patients with irMyocarditis and irMyopathy had higher high-sensitivity troponin T (median 716 ng/L vs 75 ng/L; <em>P</em> &lt; 0.001) and creatine kinase levels (median 3441 U/L vs 232 U/L; <em>P</em> &lt; 0.001) and were more likely to present with significant arrhythmias (HR: 2.12; 95% CI: 1.13-3.97; <em>P</em> = 0.019). Conversely, patients with isolated irMyocarditis had higher N-terminal prohormone of brain natriuretic peptide levels (median 2043 pg/mL vs 606 pg/mL; <em>P</em> = 0.007), lower left ventricular ejection fractions (median 56% vs 65%; <em>P</em> = 0.008), and a higher likelihood of acute decompensated heart failure (HR: 5.88; 95% CI: 1.45-25; <em>P</em> = 0.013). Cardiovascular and all-cause death during admission were numerically higher in patients with concomitant irMyopathy but were not significantly different between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Patients with irMyocarditis and irMyopathy and those with isolated irMyocarditis have distinct biomarker profiles and cardiovascular complications. These differences should be confirmed in larger prospective cohorts to guide tailored management strategies.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 252-264"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Checkpoint Inhibitor-Related Myocarditis, Myopathy, and More","authors":"Jafar Al-Mondhiry MD, MA ,&nbsp;Ana Barac MD, PhD","doi":"10.1016/j.jaccao.2025.03.004","DOIUrl":"10.1016/j.jaccao.2025.03.004","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 265-267"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Mean Heart Dose","authors":"Sophie Jacob PhD ,&nbsp;Youlia Kirova MD, PhD ,&nbsp;Eloi Marijon MD, PhD","doi":"10.1016/j.jaccao.2025.03.002","DOIUrl":"10.1016/j.jaccao.2025.03.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 231-233"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2666-0873(25)00135-8","DOIUrl":"10.1016/S2666-0873(25)00135-8","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages I-CXXXVII"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Trastuzumab-Induced Cardiac Dysfunction Risk Stratification and Surveillance","authors":"Fengqi Fang MD ,&nbsp;Xinxin Zhang MD ,&nbsp;Junjie Li MD","doi":"10.1016/j.jaccao.2025.01.011","DOIUrl":"10.1016/j.jaccao.2025.01.011","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 216-218"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Checkpoint Inhibitor Myocarditis and Left Ventricular Systolic Dysfunction","authors":"Yen-Chou Chen MD ,&nbsp;Charles Dolladille MD, PhD ,&nbsp;Anjali Rao MD ,&nbsp;Nicolas L. Palaskas MD ,&nbsp;Anita Deswal MD, MPH ,&nbsp;Lorenz Lehmann MD ,&nbsp;Jennifer Cautela MD ,&nbsp;Pierre-Yves Courand MD, PhD ,&nbsp;Salim Hayek MD, PhD ,&nbsp;Han Zhu MD ,&nbsp;Richard K. Cheng MD, MSc ,&nbsp;Joachim Alexandre MD, PhD ,&nbsp;Lauren A. Baldassarre MD ,&nbsp;François Roubille MD ,&nbsp;Michal Laufer-Perl MD ,&nbsp;Aarti Asnani MD ,&nbsp;Stephane Ederhy MD ,&nbsp;Yuichi Tamura MD, PhD ,&nbsp;Sanjeev Francis MD ,&nbsp;Elizabeth M. Gaughan MD ,&nbsp;Vlad G. Zaha MD, PhD, MBA","doi":"10.1016/j.jaccao.2025.01.020","DOIUrl":"10.1016/j.jaccao.2025.01.020","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, but ICI myocarditis (ICI-M) remains a potentially fatal complication. The clinical implications and predictors of left ventricular ejection fraction (LVEF) &lt;50% in ICI-M are not well understood.</div></div><div><h3>Objectives</h3><div>The aim of this study was to identify factors associated with LVEF &lt;50% vs ≥50% at the time of hospitalization for ICI-M. A secondary objective was to evaluate the relationship between LVEF and 30-day all-cause mortality.</div></div><div><h3>Methods</h3><div>The International ICI-Myocarditis Registry, a retrospective, international, multicenter database, included 757 patients hospitalized with ICI-M. Patients were stratified by LVEF as reduced LVEF (&lt;50%) or preserved LVEF (≥50%) on admission. Cox proportional hazards models were used to assess the associations between LVEF and clinical events, and multivariable logistic regression was conducted to examine factors linked to LVEF.</div></div><div><h3>Results</h3><div>Of 757 patients, 707 had documented LVEFs on admission: 244 (35%) with LVEF &lt;50% and 463 (65%) with LVEF ≥50%. Compared with patients with LVEF ≥50%, those with LVEF &lt;50% were younger (&lt;70 years), had a body mass index of &lt;25 kg/m², and were more likely to have received chest radiation (24.2% vs 13.5%; <em>P</em> &lt; 0.001). Multivariable analysis identified predictors of LVEF &lt;50%, including exposure to v-raf murine sarcoma viral oncogene homolog B1/mitogen-activated protein kinase inhibitors, pre-existing heart failure, dyspnea at presentation, and at least 40 days from ICI initiation to ICI-M onset. Conversely, myositis symptoms were associated with LVEF ≥50%. LVEF &lt;50% was marginally associated with 30-day all-cause mortality (unadjusted log-rank <em>P</em> = 0.062; adjusted for age, cancer types, and ICI therapy, HR: 1.50; 95% CI: 1.02-2.20).</div></div><div><h3>Conclusions</h3><div>Dyspnea, time from ICI initiation, a history of heart failure, and prior cardiotoxic therapy may be predictors of an initial LVEF &lt;50% in patients with ICI-M.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 3","pages":"Pages 234-248"},"PeriodicalIF":12.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2666-0873(25)00022-5","DOIUrl":"10.1016/S2666-0873(25)00022-5","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages I-CXII"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436491","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":"The Association of Malignancy With Stroke and Bleeding in Atrial Fibrillation","authors":"Malak El-Rayes MD ,&nbsp;Mohamed Adam MSc ,&nbsp;Jiming Fang PhD ,&nbsp;Xuesong Wang MSc ,&nbsp;Irene Jeong MSc ,&nbsp;Peter C. Austin PhD ,&nbsp;Andrew C.T. Ha MD ,&nbsp;Michael G. Fradley MD ,&nbsp;Thomas A. Boyle MD ,&nbsp;Eitan Amir MB ChB, PhD ,&nbsp;Paaladinesh Thavendiranathan MD, MSc ,&nbsp;Husam Abdel-Qadir MD, PhD","doi":"10.1016/j.jaccao.2024.10.014","DOIUrl":"10.1016/j.jaccao.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>It is undetermined if malignancy independently increases stroke risk in atrial fibrillation (AF).</div></div><div><h3>Objectives</h3><div>This study sought to determine the association of malignancy with stroke and bleeding in AF.</div></div><div><h3>Methods</h3><div>Population-based cohort study using administrative datasets of people aged ≥66 years with newly diagnosed AF. People diagnosed with malignancy within 5 years before AF diagnosis were matched to cancer-free control subjects on age, sex, AF diagnosis details, CHA₂DS₂-VASc score, and ATRIA bleeding score. Outcomes included hospitalizations for stroke and hospitalization/emergency visits for bleeding. Cause-specific regression was used to determine the HR for malignancy after adjusting for time-varying anticoagulation status. Analyses were repeated for specific subgroups of cancer patients (with matched control subjects).</div></div><div><h3>Results</h3><div>Among 199,710 AF patients, 24,991 (12.5%) people had prior malignancy. Malignancy was associated with more inpatient diagnoses of AF (vs outpatient) and less anticoagulation. We matched 43,802 people with AF (21,901 with malignancy, mean age 78.1 years; 59.5% male). After adjusting for anticoagulation status, malignancy had a similar hazard of stroke (HR: 1.01; 95% CI: 0.88-1.15) but higher hazard of bleeding (HR: 1.45; 95% CI: 1.37-1.53) compared with cancer-free control subjects in the matched sample. Analyses of cancer subgroups with comparison to matched control subjects mostly showed consistent results, except for: 1) increased hazard of stroke in lung cancer; and 2) lack of increased bleeding hazard in breast cancer and lymphoma.</div></div><div><h3>Conclusions</h3><div>People with AF and malignancy generally had similar hazards of stroke but higher hazards of bleeding compared with cancer-free control subjects, suggesting that malignancy should not lower the threshold for anticoagulation in AF.</div></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages 157-167"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437060","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":"Editorial Board/ACC Officers Page","authors":"","doi":"10.1016/S2666-0873(25)00020-1","DOIUrl":"10.1016/S2666-0873(25)00020-1","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Pages i-iv"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436492","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":"Withdrawal of Cardioprotective Therapy in Patients With Recovered Cancer Therapy–Related Cardiac Dysfunction","authors":"Yuma Shibutani PhD,&nbsp;Takuro Imaoka MD,&nbsp;Atsuko Suzuki BSc,&nbsp;Kazuko Tajiri MD, PhD","doi":"10.1016/j.jaccao.2024.11.010","DOIUrl":"10.1016/j.jaccao.2024.11.010","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"7 2","pages":"Page 189"},"PeriodicalIF":12.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437051","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}