Key result
Among oncology patients receiving immune checkpoint inhibitors, the most common cardiovascular adverse events were atrial fibrillation (4.6%), myocarditis (0.5%), and pericardial effusion (0.5%).
Why the study?
Immune checkpoint inhibitors cause common immune-related adverse effects, but cardiovascular irAEs are rare and potentially life-threatening complications whose incidence needed estimation across various malignancies.
Meta-Analysis
Cardiovascular immune-related adverse events from immune checkpoint inhibitors are rare, with atrial fibrillation, myocarditis, and pericardial effusion being the most frequently observed.
Rare CV irAEs during immune checkpoint inhibitor therapy warrant vigilance; extends incidence estimates but leaves optimal monitoring unresolved.
BACKGROUND: Immune checkpoint inhibitors (ICIs) are novel therapeutic agents used for various types of cancer. ICIs have revolutionized cancer treatment and improved clinical outcomes among cancer patients. However, immune-related adverse effects of ICI therapy are common. Cardiovascular immune-related adverse events (irAEs) are rare but potentially life-threatening complications. AIM: To estimate the incidence of cardiovascular irAEs among patients undergoing ICI therapy for various malignancies. METHODS: test and managed to solve it with Cochrane's leave-one-out method. The risk of bias was performed with the Cochrane's risk of bias tool. RESULTS: A total of 26 studies were included. The incidence of irAEs follows: Myocarditis: 0.5% [95% confidence interval (CI): 0.1%-0.9%]; Pericardial effusion: 0.5% (95%CI: 0.1%-1.0%); Heart failure: 0.3% (95%CI: 0.0%-0.5%); Cardiomyopathy: 0.3% (95%CI: -0.1%-0.6%); atrial fibrillation: 4.6% (95%CI: 1.0%-14.1%); Myocardial infarction: 0.4% (95%CI: 0.0%-0.7%); and Cardiac arrest: 0.4% (95%CI: 0.1%-0.8%). CONCLUSION: The most common cardiovascular irAEs were atrial fibrillation, myocarditis, and pericardial effusion. Although rare, data from post market surveillance will provide estimates of the long-term prevalence and prognosis in patients with ICI-associated cardiovascular complications.
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Nso et al. (2020) conducted a meta-analysis in Cancer. Immune checkpoint inhibitors was evaluated on Incidence of cardiovascular immune-related adverse events. Among oncology patients receiving immune checkpoint inhibitors, the most common cardiovascular adverse events were atrial fibrillation (4.6%), myocarditis (0.5%), and pericardial effusion (0.5%).
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