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Case Report: Cardiac Toxicity Associated With Immune Checkpoint Inhibitors

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单位: [1]Huazhong Univ Sci & Technol, Union Hosp, Dept Cardiol, Tongji Med Coll, Wuhan, Peoples R China [2]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Clin Ctr Human Gene Res, Wuhan, Peoples R China [3]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Ctr Canc, Wuhan, Peoples R China [4]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Pulm & Crit Care Med,Tongji Med Coll,Wuhan,Peoples R China [5]Natl Minist Hlth Peoples Republ China, Key Lab Resp Dis, Wuhan, Peoples R China [6]Natl Clin Res Ctr Resp Dis, Wuhan, Peoples R China
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关键词: immune checkpoint inhibitors cancer myocardial injury immune-related adverse events myocarditis

摘要:
Immune checkpoint inhibitors (ICIs) have now emerged as a mainstay of treatment for various cancer. Along with the development of ICIs, immune-related adverse effects (irAEs) have been the subject of wide attention. The cardiac irAE, a rare but potentially fatal and fulminant effect, have been reported recently. This article retrospectively reviewed 10 cases from our hospital with cardiac irAEs, with severity ranging from asymptomatic troponin-I elevations to cardiac conduction abnormalities and even fulminant myocarditis. In our series, all the cases were solid tumors and lung cancer was the most frequent cancer type (4,40%). In total, three (30.0%) patients experienced more than one type of life-threatening complication. A systemic corticosteroid was given to nine patients (90.0%). The majority of cases (7, 70%) were performed at an initial dose of 1-2 mg/kg/day. Two (20.0%) patients were admitted to ICU, three (30.0%) patients were put on mechanical ventilation, two (20.0%) patients received the plasma exchange therapy, and one patient was implanted with a pacemaker. Two (20.0%) of the patients succumbed and died, with a median duration of 7.5 days (IQR5.0-10.0) from diagnosis of cardiac irAE to death. Based on these results, we recommend that clinicians be alert to cardiac irAEs, including performing cardiovascular examinations before ICI treatment to accurately diagnose suspected myocarditis, enabling immediate initiation of immunosuppressive therapy to improve prognosis.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2019]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者单位: [1]Huazhong Univ Sci & Technol, Union Hosp, Dept Cardiol, Tongji Med Coll, Wuhan, Peoples R China [2]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Clin Ctr Human Gene Res, Wuhan, Peoples R China
通讯作者:
通讯机构: [1]Huazhong Univ Sci & Technol, Union Hosp, Dept Cardiol, Tongji Med Coll, Wuhan, Peoples R China [2]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Clin Ctr Human Gene Res, Wuhan, Peoples R China [4]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Pulm & Crit Care Med,Tongji Med Coll,Wuhan,Peoples R China [5]Natl Minist Hlth Peoples Republ China, Key Lab Resp Dis, Wuhan, Peoples R China [6]Natl Clin Res Ctr Resp Dis, Wuhan, Peoples R China
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