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Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study

An increasing number of patients with cancer are being treated with immune checkpoint inhibitors. Consequently, the incidence of immune checkpoint inhibitor-related myocarditis has been increasing. Nonetheless, the diagnostic criteria for the immune checkpoint inhibitor-related myocarditis have not...

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Autores principales: Nishikawa, Tatsuya, Inoue, Takako, Otsuka, Tomoyuki, Kuno, Ikumi, Kukita, Yoji, Nakamura, Harumi, Ikeda, Yoshihiko, Yasui, Taku, Shioyama, Wataru, Oka, Toru, Honma, Keiichirou, Hatakeyama, Kinta, Miyata, Hiroshi, Isei, Taiki, Ishihara, Ryu, Kumagai, Toru, Nishimura, Kazuo, Fujita, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665386/
https://www.ncbi.nlm.nih.gov/pubmed/36378654
http://dx.doi.org/10.1371/journal.pone.0275865
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author Nishikawa, Tatsuya
Inoue, Takako
Otsuka, Tomoyuki
Kuno, Ikumi
Kukita, Yoji
Nakamura, Harumi
Ikeda, Yoshihiko
Yasui, Taku
Shioyama, Wataru
Oka, Toru
Honma, Keiichirou
Hatakeyama, Kinta
Miyata, Hiroshi
Isei, Taiki
Ishihara, Ryu
Kumagai, Toru
Nishimura, Kazuo
Fujita, Masashi
author_facet Nishikawa, Tatsuya
Inoue, Takako
Otsuka, Tomoyuki
Kuno, Ikumi
Kukita, Yoji
Nakamura, Harumi
Ikeda, Yoshihiko
Yasui, Taku
Shioyama, Wataru
Oka, Toru
Honma, Keiichirou
Hatakeyama, Kinta
Miyata, Hiroshi
Isei, Taiki
Ishihara, Ryu
Kumagai, Toru
Nishimura, Kazuo
Fujita, Masashi
author_sort Nishikawa, Tatsuya
collection PubMed
description An increasing number of patients with cancer are being treated with immune checkpoint inhibitors. Consequently, the incidence of immune checkpoint inhibitor-related myocarditis has been increasing. Nonetheless, the diagnostic criteria for the immune checkpoint inhibitor-related myocarditis have not been sufficiently established. Therefore, the real-world incidence or prevalence of immune checkpoint inhibitor-related myocardial damage remains unknown. This was a single-center cohort study that included 100 patients admitted for immune checkpoint inhibitor therapy for any type of cancer. The patients underwent monthly measurement of cardiac troponin I and N-terminal pro-brain natriuretic peptide levels with electrocardiography. Additionally, echocardiography was performed every 3 months. Our protocol was continued until 6 months after the initiation of immune checkpoint inhibitors. We defined immune checkpoint inhibitor-related myocardial damage as an increase in cardiac troponin I levels by >0.026 ng/mL and/or a decrease in the left ventricular ejection fraction by >10% to <53% on echocardiography. The mean patient age was 64 years; 71% were men. The most commonly used immune checkpoint inhibitor was nivolumab (47%), followed by pembrolizumab (29%). Overall, 5% of patients received combination therapy. Among 100 patients, 10 (10%) were diagnosed with immune checkpoint inhibitor-related myocardial damage. Among them, five patients underwent endomyocardial biopsy. Of these patients, four were histopathologically observed to have lymphocyte infiltration in their myocardium. In conclusion, serial cardiac troponin I measurement during immune checkpoint inhibitor treatment could help detect early-phase myocardial damage. The prevalence of myocardial damage was much higher than previously expected.
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spelling pubmed-96653862022-11-15 Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study Nishikawa, Tatsuya Inoue, Takako Otsuka, Tomoyuki Kuno, Ikumi Kukita, Yoji Nakamura, Harumi Ikeda, Yoshihiko Yasui, Taku Shioyama, Wataru Oka, Toru Honma, Keiichirou Hatakeyama, Kinta Miyata, Hiroshi Isei, Taiki Ishihara, Ryu Kumagai, Toru Nishimura, Kazuo Fujita, Masashi PLoS One Research Article An increasing number of patients with cancer are being treated with immune checkpoint inhibitors. Consequently, the incidence of immune checkpoint inhibitor-related myocarditis has been increasing. Nonetheless, the diagnostic criteria for the immune checkpoint inhibitor-related myocarditis have not been sufficiently established. Therefore, the real-world incidence or prevalence of immune checkpoint inhibitor-related myocardial damage remains unknown. This was a single-center cohort study that included 100 patients admitted for immune checkpoint inhibitor therapy for any type of cancer. The patients underwent monthly measurement of cardiac troponin I and N-terminal pro-brain natriuretic peptide levels with electrocardiography. Additionally, echocardiography was performed every 3 months. Our protocol was continued until 6 months after the initiation of immune checkpoint inhibitors. We defined immune checkpoint inhibitor-related myocardial damage as an increase in cardiac troponin I levels by >0.026 ng/mL and/or a decrease in the left ventricular ejection fraction by >10% to <53% on echocardiography. The mean patient age was 64 years; 71% were men. The most commonly used immune checkpoint inhibitor was nivolumab (47%), followed by pembrolizumab (29%). Overall, 5% of patients received combination therapy. Among 100 patients, 10 (10%) were diagnosed with immune checkpoint inhibitor-related myocardial damage. Among them, five patients underwent endomyocardial biopsy. Of these patients, four were histopathologically observed to have lymphocyte infiltration in their myocardium. In conclusion, serial cardiac troponin I measurement during immune checkpoint inhibitor treatment could help detect early-phase myocardial damage. The prevalence of myocardial damage was much higher than previously expected. Public Library of Science 2022-11-15 /pmc/articles/PMC9665386/ /pubmed/36378654 http://dx.doi.org/10.1371/journal.pone.0275865 Text en © 2022 Nishikawa et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nishikawa, Tatsuya
Inoue, Takako
Otsuka, Tomoyuki
Kuno, Ikumi
Kukita, Yoji
Nakamura, Harumi
Ikeda, Yoshihiko
Yasui, Taku
Shioyama, Wataru
Oka, Toru
Honma, Keiichirou
Hatakeyama, Kinta
Miyata, Hiroshi
Isei, Taiki
Ishihara, Ryu
Kumagai, Toru
Nishimura, Kazuo
Fujita, Masashi
Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study
title Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study
title_full Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study
title_fullStr Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study
title_full_unstemmed Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study
title_short Prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: A prospective observational study
title_sort prevalence and characteristics of immune checkpoint inhibitor-related myocardial damage: a prospective observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665386/
https://www.ncbi.nlm.nih.gov/pubmed/36378654
http://dx.doi.org/10.1371/journal.pone.0275865
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