JACC:免疫抑制剂治疗后心肌炎的临床特征研究

2018-04-23 MedSci MedSci原创

心肌炎虽然不常见,但是在接受免疫抑制剂(ICI)治疗后存在潜在致命性的风险。本研究的目的旨在评估ICI相关心肌炎的临床特征和预后。本研究纳入了2013年至2017年来自8个注册中心的35名ICI相关心肌炎患者,并与105名接受ICI治疗但未出现心肌炎的患者作为对照。主要观察事件是心血管主要不良反应事件(MACE),包括心血管源性死亡、心源性休克、心源性猝死和完全性心脏传导阻滞。分析结果显示,ICI

心肌炎虽然不常见,但是在接受免疫抑制剂(ICI)治疗后存在潜在致命性的风险。本研究的目的旨在评估ICI相关心肌炎的临床特征和预后。

本研究纳入了2013年至2017年来自8个注册中心的35名ICI相关心肌炎患者,并与105名接受ICI治疗但未出现心肌炎的患者作为对照。主要观察事件是心血管主要不良反应事件(MACE),包括心血管源性死亡、心源性休克、心源性猝死和完全性心脏传导阻滞。分析结果显示,ICI治疗后出现心肌炎的比率约为1.14%,平均出现时间是34天,病例组患者的平均年龄为65 ± 13岁,女性占29%,54%患者未出现其他免疫相关性副作用。与对照组相比,ICI与糖尿病在病例组中更常见,经过平均102天时间的随访,病例组中有16名(46%)患者发展为MACE,38%的MACE事件伴有正常的射血分数,在肌钙蛋白≥1.5 ng/ml的患者中,MACE发生的风险要高四倍(HR:4.0; 95% Cl: 1.5 - 10.9; p = 0.003)。此外,低的类固醇水平与高的MACE发生风险相关。

研究结果显示,ICI治疗后心肌炎的发病率要高于预期,并且出现时间较早,预后差,对高剂量的类固醇敏感。

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    2018-12-28 jklm09
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    2018-07-26 hbwxf
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    2018-04-23 smartxiuxiu

    0

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