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Routine assessment of cardiotoxicity in patients undergoing long-term immune checkpoint inhibitor therapy

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Abstract

The indications for immune checkpoint inhibitors (ICIs) are expanding in cancer drug therapy, and while cardiac events associated with ICIs are often fatal, there are few reports regarding cardiac complications associated with long-term ICI therapy. We aimed to study cardiac complications in patients undergoing long-term ICI therapy. From the database of our local cardio-oncology unit, we enrolled patients with cancer undergoing ICI therapy for more than 6 months and for whom cardiologists continuously performed routine follow-ups. We defined the primary endpoint as discontinuation of ICI due to cardiac events. We also analyzed changes in cardiac biomarkers and echocardiographic parameters. We retrospectively analyzed 55 consecutive patients (43 males, mean age: 65 ± 11 years) treated with ICI therapy in our hospital between January 2017 and June 2021. None of the patients discontinued ICI therapy due to cardiac events more than 6 months after treatment was initiated. Among the participants, we observed four patients with elevated serum troponin I levels, seven patients with decreased global longitudinal strain values, and two patients with elevated plasma brain natriuretic peptide levels. No patient required drug intervention for these cardiac events; furthermore, there were no cases of clinically diagnosed myocarditis. In the present study, there were no cardiac events causing ICI discontinuation in patients undergo ICI therapy for more than 6 months.

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Acknowledgements

We would like to express our gratitude to all the participants and staff involved in this study, especially Rika Takeyasu and Yui Shiga for data management, and Chihiro Fukuda, Kotomi Tsukamoto and Yuka Murakami for data collection.

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Authors and Affiliations

  1. Cardiovascular Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan

    Yudai Tamura, Kenta Yamada, Hirohisa Taniguchi, Jin Iwasawa & Hirotaka Yada

  2. Pulmonary Hypertension Center, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan

    Yuichi Tamura

  3. Department of Cardiology, International University of Health and Welfare School of Medicine, Narita, Japan

    Yudai Tamura, Yuichi Tamura, Kenta Yamada, Hirohisa Taniguchi, Hirotaka Yada & Akio Kawamura

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  1. Yudai Tamura
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  2. Yuichi Tamura
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  3. Kenta Yamada
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  4. Hirohisa Taniguchi
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  5. Jin Iwasawa
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Correspondence to Yuichi Tamura.

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Tamura, Y., Tamura, Y., Yamada, K. et al. Routine assessment of cardiotoxicity in patients undergoing long-term immune checkpoint inhibitor therapy. Heart Vessels 37, 1859–1865 (2022). https://doi.org/10.1007/s00380-022-02103-1

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  • DOI: https://doi.org/10.1007/s00380-022-02103-1

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