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Cited by 508Cancer Immunotherapy and BiomarkersChemotherapy-induced cardiotoxicity and mitigationCardiac tumors and thrombi

Cardiovascular toxicities associated with immune checkpoint inhibitors

Open access
Hu, Jiun-Ruey, Florido, Roberta, Lipson, Evan J, Naidoo, Jarushka, Ardehali, Reza, Tocchetti, Carlo G, Lyon, Alexander R, Padera, Robert F +2 more·2019·Cardiovascular Research
DOI 10.1093/cvr/cvz026PMC PMC6452314
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Abstract

Cardiovascular toxicities associated with immune checkpoint inhibitors (ICIs) have been reported in case series but have been underappreciated due to their recent emergence, difficulties in diagnosis and non-specific clinical manifestations. ICIs are antibodies that block negative regulators of the T cell immune response, including cytotoxic T lymphocyte-associated protein-4 (CTLA-4), programmed cell death protein-1 (PD-1), and PD-1 ligand (PD-L1). While ICIs have introduced a significant mortality benefit in several cancer types, the augmented immune response has led to a range of immune-related toxicities, including cardiovascular toxicity. ICI-associated myocarditis often presents with arrhythmias, may co-exist with myositis and myasthenia gravis, can be severe, and portends a poor prognosis. In addition, pericardial disease, vasculitis, including temporal arteritis, and non-inflammatory heart failure, have been recently described as immune-related toxicities from ICI. This narrative review describes the epidemiology, diagnosis, pathophysiology, and treatment of cardiovascular toxicities of ICI therapy, highlighting recent developments in the field in the past year.

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  • ICI myocarditis is an infrequent but potentially fatal condition associated with ICI therapies, especially when used in combination.

    “ICI myocarditis emerges as an infrequent but potentially fatal condition associated with ICI therapies, especially when used in combination”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [36]

  • Immune checkpoint inhibitors are associated with myocarditis.

    “immune checkpoint inhibitors (ICIs), which activate the immune system and have proven effective in therapies, are associated with myocarditis”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [36]

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Cited by

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Authors
Hu, J.-R., Florido, R., Lipson, E. J., Naidoo, J., Ardehali, R., Tocchetti, C. G., Lyon, A. R., Padera, R. F., Johnson, D. B., & Moslehi, J.
Affiliations
  • Vanderbilt University Medical Center (US)
  • Johns Hopkins University (US)
  • University of California, Los Angeles (US)
  • University of Naples Federico II (IT)
  • Royal Brompton Hospital (GB)
  • Brigham and Women's Hospital (US)
Corresponding author
Moslehi, Javid
ORCID
Venue
Cardiovascular Research
Publisher
Oxford University Press (OUP)
Published
2019-02-02
Volume
115
Issue
5
Pages
854-868
ISSN
  • 0008-6363 (ISSN-L)
  • 1755-3245
DOI
10.1093/cvr/cvz026
PMC
PMC6452314
OpenAlex
W2913202760
Cited by
508
References
6
Citations by year
2026: 51 · 2025: 61 · 2024: 87 · 2023: 66 · 2022: 92 · 2021: 70 · 2020: 57 · 2019: 23
FWCI
5.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Cardiovascular Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
NIH (R56HL141466)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
Keywords
immune checkpoint inhibitors, immune-related adverse events, cardiotoxicity, immune-related myocarditis, cardiac arrhythmias, pericardial disease, vasculitis, giant cell arteritis, heart failure, CTLA-4, PD-1, PD-L1, myositis, myasthenia gravis, pathophysiology, diagnosis, treatment
MeSH terms
Antineoplastic Agents, Immunological, Animals, Cardiovascular Diseases, Humans, Myocarditis, Neoplasms, Pericarditis, Prognosis, Risk Factors, Vasculitis, Risk Assessment, Cardiotoxicity

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