Evidence map›Paper›PMID 34049595›Full record

ArticleCardio-oncology (London, England)2021

A retrospective analysis of cardiovascular adverse events associated with immune checkpoint inhibitors.

Jessica Castrillon Lal, Sherry-Ann Brown, Patrick Collier, Feixiong Cheng

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardio-oncology (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Jessica Castrillon LalGenomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Sherry-Ann BrownCardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Patrick CollierDepartment of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA.
Feixiong ChengGenomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA. chengf@ccf.org.
Case Western Reserve University · USMedical College of Wisconsin · US

Funding

An individualized network medicine infrastructure for precision cardio-oncologyR00HL138272 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI CHENG, FEIXIONG · 2018 to 2020
$747k
An individualized network medicine infrastructure for precision cardio-oncologyK99HL138272 · NHLBI · NORTHEASTERN UNIVERSITY · PI CHENG, FEIXIONG · 2017 to 2017
$86k
NHLBI NIH HHS K99 HL138272NHLBI NIH HHS R00 HL138272
6 · The paper itself

Abstract

backgroundModern therapies in oncology have increased cancer survivorship, as well as the incidence of cardiovascular adverse events. While immune checkpoint inhibitors have shown significant clinical impact in several cancer types, the incidence of immune-related cardiovascular (CV) adverse events poses an additional health concern and has been reported.

methodsWe performed a retrospective analysis of the FDA Adverse Event Reporting System data of suspect product reports for immunotherapy and classical chemotherapy from January 2010-March 2020. We identified 90,740 total adverse event reports related to immune checkpoint inhibitors and classical chemotherapy.

resultsWe found that myocarditis was significantly associated with patients receiving anti-program cell death protein 1 (PD-1) or anti-program death ligand 1 (PD-L1), odds ratio (OR) = 23.86 (95% confidence interval [CI] 11.76-48.42, (adjusted p-value) q <  0.001), and combination immunotherapy, OR = 7.29 (95% CI 1.03-51.89, q = 0.047). Heart failure was significantly associated in chemotherapy compared to PD-(L)1, OR = 0.50 (95% CI 0.37-0.69, q <  0.001), CTLA4, OR = 0.08 (95% CI 0.03-0.20, q <  0.001), and combination immunotherapy, OR = 0.25 (95% CI 0.13-0.48, q <  0.001). Additionally, we observe a sex-specificity towards males in cardiac adverse reports for arrhythmias, OR = 0.81 (95% CI 0.75-0.87, q <  0.001), coronary artery disease, 0.63 (95% CI 0.53-0.76, q <  0.001), myocardial infarction, OR = 0.60 (95% CI 0.53-0.67, q <  0.001), myocarditis, OR = 0.59 (95% CI 0.47-0.75, q <  0.001) and pericarditis, OR = 0.5 (95% CI 0.35-0.73, q <  0.001).

conclusionOur study provides the current risk estimates of cardiac adverse events in patients treated with immunotherapy compared to conventional chemotherapy. Understanding the clinical risk factors that predispose immunotherapy-treated cancer patients to often fatal CV adverse events will be crucial in Cardio-Oncology management.

Indexed as

Cardio-oncologyCardiotoxicityImmune checkpoint inhibitorsImmunotherapyMyocardial infarctionMyocarditis

Identifiers

PMID34049595
PMCPMC8161966
OpenAlexW3165602720

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.