Association of Cardiovascular Comorbidities on in-Hospital Outcomes of CAR T-Cell Therapy Recipients in the United States.

Introduction: With expanding indications for chimeric antigen receptor T-cell (CAR-T) therapy, more patients with diverse clinical profiles are receiving treatment, some of whom may not have been eligible to enroll on the pivotal clinical trials. The impact of preexisting cardiovascular diseases (CVDs) on the outcomes of CAR-T recipients remains understudied.

Methods: Our study aimed to evaluate the impact of preexisting CVD on in-hospital outcomes among patients who received CAR-T therapy using the Nationwide Readmissions Database (NRD) from 2018 to 2020. We analyzed patients aged ≥18 and compared outcomes between those with and without preexisting CVD, utilizing sampling weights for national estimates.

Results: After weighting, the cohort included 4,950 patients: 2,312 (46.7%) and 2,638 (53.3%) with and without preexisting CV, respectively. Patients with preexisting CVD experienced significantly higher rates of acute heart failure (2.9% vs. 0.7%; p = 0.01), myocardial infarction (2.2% vs. 0.9%; p < 0.01), cerebrovascular accidents (1.4% vs. 0.7%; p < 0.01), and acute kidney injury (19.2% vs. 13.3%; p < 0.01). Rates of cardiogenic shock, cardiac arrest, and pulmonary embolism were comparable between these 2 groups. Multivariate analysis showed preexisting CVD was not associated with increased odds of early mortality {adjusted odd ratios (aOR) = 1.01 (95% confidence intervals [CIs], 0.69-1.49), p = 0.95}, prolonged index hospitalization (aOR = 0.94 [95% CI, 0.64-1.36], p = 0.73), non-home discharge (aOR 1.04 [95% CI, 0.79-1.38], p = 0.77), and 30-day readmission (aOR 0.99 [95% CI, 0.81-1.20], p = 0.91).

Conclusion: Although there were significant differences in acute complications, our study reinforces that the presence of CVD does not adversely affect early mortality rates.