Immune checkpoint inhibitors in lung cancer patients nearly double 180-day MACE risk (HR 1.98), with prior heart failure (HR 3.08) and chronic renal failure (HR 2.16) as key factors.
Do immune checkpoint inhibitors increase the risk of major adverse cardiovascular events in primary lung cancer patients compared to non-ICI chemotherapy?
Immune checkpoint inhibitors significantly increase the risk of major adverse cardiovascular events in primary lung cancer patients, particularly among those with pre-existing heart failure or chronic renal failure.
Absolute Event Rate: 0% vs 0%
Abstract Background Large, diverse cohort studies are essential for determining the incidence and risk factors of major adverse cardiovascular events (MACEs) associated with immune checkpoint inhibitors (ICIs). Purpose This study aimed to (1) compare the incidence of MACEs in primary lung cancer patients receiving ICIs versus those receiving non-ICI chemotherapy and (2) identify potential risk factors for MACEs in ICI-treated patients. Materials and Methods We performed a retrospective analysis of primary lung cancer patients using a nationwide Japanese database. Patients were stratified by their use of ICIs. After propensity score matching, outcomes were evaluated over 180 days. Results The study included 743 propensity-matched patients in each cohort. At 180 days, 4.0% of ICI-treated patients experienced MACEs, significantly higher than in patients treated with non-ICI chemotherapy (hazard ratio HR, 1.98; 95% confidence interval CI, 1.07–3.69; P-value = 0.030). Heart failure was the most common MACE (1.7%), followed by acute coronary syndromes (0.8%), myocarditis (0.5%), cardiac or sudden death (0.5%), and pericarditis (0.5%). The median follow-up period was 329 days (interquartile range, 147–625). In multivariable analysis, chronic renal failure (HR, 2.16; 95% CI, 1.05–4.46; P-value = 0.038) and prior heart failure (HR, 3.08; 95% CI, 1.86–5.11; P-value 0.001) were significant risk factors for MACEs. Conclusion ICI treatment in primary lung cancer patients is associated with an increased cardiovascular risk, particularly among those with prior heart failure or chronic renal failure. These findings underscore the importance of vigilant cardiovascular monitoring in patients with these pre-existing conditions.Study flow Graphical abstract
Isawa et al. (Sat,) reported a other. Immune checkpoint inhibitors in lung cancer patients nearly double 180-day MACE risk (HR 1.98), with prior heart failure (HR 3.08) and chronic renal failure (HR 2.16) as key factors.