ArticleCirculation2020
Association Between Immune Checkpoint Inhibitors With Cardiovascular Events and Atherosclerotic Plaque.
Article in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 341 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
341 citing papers in PubMed, 5 syntheses or guidelines pooled it, 517 citations in OpenAlex.
- The Cardiotoxicity Risk of Immune Checkpoint Inhibitors Compared with Chemotherapy: A Systematic Review and Meta-analysis of Observational Studies.Cardiovascular toxicology · 2025Pooled it
- Effect of immune checkpoint inhibitor therapy on biventricular mechanics in cancer patients over a short-term follow-up: a systematic review.Frontiers in immunology · 2025Pooled it
- Cardiovascular toxicity induced by immunotherapy in non-small cell lung cancer: a systematic review and meta-analysis of observational studies.Frontiers in oncology · 2025Pooled it
- Immune Checkpoint Inhibitors and Cardiotoxicity: A Comparative Meta-Analysis of Observational Studies and Randomized Controlled Trials.Journal of the American Heart Association · 2024Pooled it
- A bibliometric analysis of immunotherapy for atherosclerosis: trends and hotspots prediction.Frontiers in immunology · 2024Pooled it
- Mapping the global landscape of research on immune checkpoint inhibitor-associated cardiotoxicity: A quantitative and visualized bibliometric study (2016-2025).Human vaccines & immunotherapeutics · 2026Article
- Oncologic Benefits and Cardiovascular Risks of Pembrolizumab: Insights From a Nationwide Lung Adenocarcinoma Cohort.JACC. Asia · 2026Article
- Genetic and Molecular Determinants of Cancer Therapy-Related Cardiovascular Toxicity.Cardiovascular toxicology · 2026Review
- Review
- Dyslipidaemias in cancer patients.European heart journal · 2026Review
- A narrative review of immune checkpoint inhibitor-related cardiotoxicity in lung cancer: mechanisms, risk stratification, and clinical management.Journal of thoracic disease · 2026Review
- Cardiotoxicity of Immune Checkpoint Inhibitors and Chimeric Antigen Receptor T-Cell Therapy.Journal of cardiovascular development and disease · 2026Review
- Functional Heterogeneity of Immune Cell Subpopulations in Atherosclerosis: From Basic Mechanisms to Precision Therapy.Reviews in cardiovascular medicine · 2026Review
- Risk factors associated with cardiovascular hospital admissions and all-cause mortality in cancer patients treated with immune checkpoint inhibitors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Cancer-associated arterial thromboembolism: real-world burden from a nationwide electronic health record database.Journal of the National Cancer Institute · 2026Article
- Troponin Screening and Major Cardiovascular Adverse Events During Immune Checkpoint Inhibitor Therapy.JAMA network open · 2026Observational
- Atherosclerotic Cardiovascular Disease and Cancer.Immunological reviews · 2026Review
- Multimodality imaging in the detection and management of coronary and peripheral arterial disease in patients with cancer receiving cardiotoxic antineoplastic treatments: A clinical consensus statement of the ESC Council of Cardio-Oncology and the European Association of Cardiovascular Imaging (EACVI) of the ESC.European heart journal. Cardiovascular Imaging · 2026Review
- Association between comorbidities and major adverse cardiovascular events in patients undergoing immune checkpoint blockade.BMC cancer · 2026Article
- Inhibition of the programmed death protein 1 immune checkpoint and the development of heart failure in the presence of prior cardiac ischaemia.Cardiovascular research · 2026Article
281 more citing papers are in PubMed but not listed here.
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Authors and funding
20 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundImmune checkpoint inhibitors (ICIs) treat an expanding range of cancers. Consistent basic data suggest that these same checkpoints are critical negative regulators of atherosclerosis. Therefore, our objectives were to test whether ICIs were associated with accelerated atherosclerosis and a higher risk of atherosclerosis-related cardiovascular events.
methodsThe study was situated in a single academic medical center. The primary analysis evaluated whether exposure to an ICI was associated with atherosclerotic cardiovascular events in 2842 patients and 2842 controls matched by age, a history of cardiovascular events, and cancer type. In a second design, a case-crossover analysis was performed with an at-risk period defined as the 2-year period after and the control period as the 2-year period before treatment. The primary outcome was a composite of atherosclerotic cardiovascular events (myocardial infarction, coronary revascularization, and ischemic stroke). Secondary outcomes included the individual components of the primary outcome. In addition, in an imaging substudy (n=40), the rate of atherosclerotic plaque progression was compared from before to after the ICI was started. All study measures and outcomes were blindly adjudicated.
resultsIn the matched cohort study, there was a 3-fold higher risk for cardiovascular events after starting an ICI (hazard ratio, 3.3 [95% CI, 2.0-5.5];
conclusionsCardiovascular events were higher after initiation of ICIs, potentially mediated by accelerated progression of atherosclerosis. Optimization of cardiovascular risk factors and increased awareness of cardiovascular risk before, during, and after treatment should be considered among patients on an ICI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.