与未使用免疫检查点抑制剂者相比,接受免疫检查点抑制剂治疗的癌症患者的心血管和静脉血栓栓塞风险--一项多中心回顾性研究。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Jian-Rong Peng, Jason Chia-Hsun Hsieh, Chih-Hao Chang, Chi Chuang, Yu-Ching Wang, Tzu-Yang Chen, Hung-Chi Su, Hsin-Fu Lee
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引用次数: 0

摘要

背景:免疫检查点抑制剂(ICIs)给癌症治疗带来了革命性的变化。本研究探讨了ICIs与非ICI疗法相比的心血管风险:这项回顾性研究利用台湾长庚研究数据库(CGRD)分析了188225名癌症患者,其中1737人在2008年1月1日至2021年6月30日期间接受了ICI治疗。通过 1:1 倾向性评分匹配(PSM),我们比较了接受 ICIs 治疗和未接受 ICIs 治疗的患者的具体结果。在评估 PSM 后的结果时,分析还考虑了死亡率这一竞争风险。观察期从这一指标日期开始,直至特定结果日期、最后一次随访记录日期或 2022 年 6 月 30 日研究结束日期,以先到者为准:研究发现,与接受非 ICI 治疗的患者相比,接受 ICI 治疗的患者发生心源性死亡、非致死性心肌梗死、心力衰竭住院、深静脉血栓或肺栓塞的风险没有明显增加。有趣的是,ICI 治疗与较低的非致命中风风险有关(每年 0.27% 对每年 0.46%;亚分布危险比 = 0.59;95% 置信区间 = 0.35-0.98;P = 0.0430)。此外,亚组分析显示,在头颈部癌症以外的癌症患者中,ICI组的心脏死亡风险降低,糖尿病患者的中风风险降低:ICIs不会明显增加癌症患者发生心血管事件的风险,还可能降低中风风险,因此需要进行更多的前瞻性研究来澄清这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular and venous thromboembolism risks in cancer patients treated with immune checkpoint inhibitors compared to non-users- a multi-center retrospective study.

Background: Immune Checkpoint Inhibitors (ICIs) have revolutionized cancer therapy. This study examines the cardiovascular risks of ICIs compared to non-ICI therapies.

Methods: Utilizing the Chang Gung Research Database (CGRD) of Taiwan, this retrospective study analyzed 188,225 cancer patients, with 1,737 undergoing ICI treatment from January 1, 2008, to June 30, 2021. Through 1:1 propensity score matching (PSM), we compared specific outcomes between patients treated with ICIs and those who were not. The analysis also accounted for the competing risk of mortality in assessing the results after PSM. The observation period spanned from this index date to whichever came first: the date of the specific outcomes, the last follow-up recorded, or the end date of the study on June 30, 2022.

Results: The study found no significant increase in the risk of cardiac death, non-fatal myocardial infarction, heart failure hospitalization, deep vein thrombosis, or pulmonary embolism in patients treated with ICIs as compared to those receiving non-ICI therapy. Interestingly, ICI treatment was linked to a lower risk of non-fatal stroke (0.27% per year vs. 0.46% per year; subdistribution hazard ratio = 0.59; 95% confidence interval = 0.35-0.98; P = 0.0430). Furthermore, subgroup analysis revealed that the ICI group had a decreased risk of cardiac death in patients with cancers other than head and neck cancer, and a reduced risk of stroke among diabetic patients.

Conclusions: ICIs do not significantly elevate the risk of cardiovascular events in cancer patients and may lower the stroke risk, underscoring the need for additional prospective studies to clarify these findings.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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