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Introduction <p>Immune checkpoint inhibitor(ICI) induced cardiac immune related adverse events are challenging to study; Leveraging large data bases like TriNetX global health network may provide needed insights.</p> Methods <p>We performed a retrospective cohort study including patients diagnosed neoplasm and 18 and older when receiving ICI therapy from 1/1/2011 to 12/31/2022. Queried ICD 9/10 codes identified patients experiencing myocarditis, pericarditis, pericardial effusion, and cardiac tamponade within 1&#xa0;year of ICI initiation. Survival analyses compared one-year overall survival (OS) of patients experiencing cardiac irAEs against propensity score matched populations not experiencing them.</p> Results <p>In 88,928 identified ICI patients, the incidence of myocarditis(0.48%), pericarditis(0.22%), and cardiac tamponade(0.47%) were less than 1% while pericardial effusion occurred in 4.71% of patients. Hazard ratios (HRs) were significantly higher in all cardiac irAE groups: myocarditis (HR:1.26, 95% CI:1.04–1.54, <i>p</i> = 0.02), pericarditis (HR:1.36, 95% CI:1.02–1.82, <i>p</i> = 0.04), pericardial effusion (HR:1.49, 95% CI:1.39–1.59, <i>p</i> &lt; 0.0001), cardiac tamponade (HR:2.15, 95% CI:1.79–2.57, <i>p</i> &lt; 0.0001), and overall pericardial disease (HR:1.46, 95% CI:1.37–1.56, <i>p</i> &lt; 0.0001). There was no significant difference in OS between myocarditis and pericarditis or overall pericardial diseases.</p> Discussion/conclusion <p>Utilizing a uniquely large cohort of ICI patients, this study further shows the rarity of cardiac inflammatory irAEs and highlights their significant impact on patient survival.</p>

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Incidence and survival outcomes of myocarditis and pericardial diseases associated with immune checkpoint inhibitor therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月5日

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  • Aya F. Ozaki,
  • Michael Sayer,
  • Hirofumi Hamano,
  • Misako Nagasaka,
  • Benjamin J. Lee,
  • Jean Doh,
  • Ali Naqvi,
  • Nareh Nowrouzi,
  • Yoshito Zamami,
  • Pranav M. Patel

摘要

Introduction

Immune checkpoint inhibitor(ICI) induced cardiac immune related adverse events are challenging to study; Leveraging large data bases like TriNetX global health network may provide needed insights.

Methods

We performed a retrospective cohort study including patients diagnosed neoplasm and 18 and older when receiving ICI therapy from 1/1/2011 to 12/31/2022. Queried ICD 9/10 codes identified patients experiencing myocarditis, pericarditis, pericardial effusion, and cardiac tamponade within 1 year of ICI initiation. Survival analyses compared one-year overall survival (OS) of patients experiencing cardiac irAEs against propensity score matched populations not experiencing them.

Results

In 88,928 identified ICI patients, the incidence of myocarditis(0.48%), pericarditis(0.22%), and cardiac tamponade(0.47%) were less than 1% while pericardial effusion occurred in 4.71% of patients. Hazard ratios (HRs) were significantly higher in all cardiac irAE groups: myocarditis (HR:1.26, 95% CI:1.04–1.54, p = 0.02), pericarditis (HR:1.36, 95% CI:1.02–1.82, p = 0.04), pericardial effusion (HR:1.49, 95% CI:1.39–1.59, p < 0.0001), cardiac tamponade (HR:2.15, 95% CI:1.79–2.57, p < 0.0001), and overall pericardial disease (HR:1.46, 95% CI:1.37–1.56, p < 0.0001). There was no significant difference in OS between myocarditis and pericarditis or overall pericardial diseases.

Discussion/conclusion

Utilizing a uniquely large cohort of ICI patients, this study further shows the rarity of cardiac inflammatory irAEs and highlights their significant impact on patient survival.