Key result
Pre-existing CVD is linked to ~12% higher 5-year mortality in patients receiving ICI therapy.
Why the study?
The impact of baseline cardiovascular disease on survival in patients undergoing immune checkpoint inhibitor therapy is not well understood.
Does pre-existing cardiovascular disease increase mortality in patients receiving immune checkpoint inhibitor therapy?
Cohort (n=62,280)
Yes
Does pre-existing cardiovascular disease increase mortality in patients receiving immune checkpoint inhibitor therapy?
Pre-existing cardiovascular disease is associated with significantly increased mortality in patients receiving immune checkpoint inhibitor therapy, highlighting the critical need for baseline cardiovascular risk assessment in this population.
Answers are grounded in this paper and cite their sources.
May warrant closer CV monitoring in ICI recipients; leaves open whether targeted interventions improve survival.
BACKGROUND: The impact of baseline cardiovascular disease (CVD) on survival in patients undergoing immune checkpoint inhibitor (ICI) therapy is not well understood. Therefore, we sought to determine the relationship between baseline CVD on mortality in patients undergoing ICI monotherapy or combination therapy. METHODS: Using TriNetX, a global database of over 120 million patients, we identified 27,820 patients with pre-existing cardiovascular disease prior to starting ICI monotherapy and an equal number of corresponding matched controls. RESULTS: Systolic heart failure (HR: 1.38, 95% CI: 1.29-1.48), diastolic heart failure (HR: 1.34, 95% CI: 1.27-1.42), and atrial fibrillation/flutter (HR: 1.24, 95% CI: 1.19-1.29) had the greatest associations with mortality across ICI monotherapy. CONCLUSION: Future trials of patients initiating ICI therapy should capture these baseline values to guide risk assessment, pretreatment optimization, and surveillance strategies prior to treatment initiation.
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Mahadevan et al. (2025) conducted a cohort in Pre-existing cardiovascular disease in cancer patients on immune checkpoint inhibitors (n=62,280). Pre-existing cardiovascular disease vs. No pre-existing cardiovascular disease was evaluated on Mortality within 5 years of the index event (HR 1.12, 95% CI 1.09-1.14, p=<0.001). Pre-existing cardiovascular disease was significantly associated with increased 5-year mortality (HR 1.12) in cancer patients receiving immune checkpoint inhibitor monotherapy.
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