Physician Update: AHA Special Edition
Read more articles from our most relevant research presented at the 2021 AHA Scientific Sessions.
Clinical Heart and Vascular Center
Associate Professor of Internal Medicine
Oncological immunotherapies have revolutionized the treatment of patients with cancer in the past decade. Immune checkpoint inhibitor (ICI) utilization continues to increase, significantly improving outcomes for many cancers. This class of antineoplastic therapy does, however, carry cardiovascular complications – most notably acute, potentially fatal autoimmune myocarditis, although the overall prevalence of immune-related myocardial injury is not well understood. In response to this potential complication, several institutions have incorporated surveillance protocols for the early detection of myocardial injury in this population.
"These data suggest a role for cardiac-specific biomarker surveillance in this patient population, both to enhance risk-stratification as well as to design preventive or therapeutic strategies."
At #AHA22, I (VZ) proposed and moderated a session that explored the intersection of immuno-oncological therapies and the cardiovascular system. Several new ideas were discussed regarding ICI-induced myocarditis:
In a separate session, one of us (AR) presented data on the prevalence of cardiac injury, as defined by high-sensitivity troponin I (hs-TnI) elevation, in patients undergoing treatment with ICI at UT Southwestern. The universal definition of myocardial infarction was used to identify patients with cardiac injury at baseline and after initiation of ICI therapy. We found a significant association between acute (on ICI therapy) or acute-on-chronic (at baseline with further elevation on ICI therapy) cardiac injury and all-cause mortality in patients undergoing treatment with ICI. These data suggest a role for cardiac-specific biomarker surveillance in this patient population, both to enhance risk-stratification as well as to design preventive or therapeutic strategies.