A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity

Abstract This study aimed to find the association between four common clinical biomarkers and subsequent ICICT, developing a risk scoring strategy to assess the ICICT risk. Three terminals for ICICT were : Terminal 1, cancer therapy-related cardiomyopathies; Terminal 2, myocarditis or heart failure;...

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Main Authors: Zhulu Chen, Rui Lan, Tao Ran, Li Tao, Yuxi Zhu, Yanwei Li, Chuan Zhang, Min Mao, Diansa Gao, Zhong Zuo
Format: Article
Language:English
Published: Nature Portfolio 2024-10-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-76829-5
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author Zhulu Chen
Rui Lan
Tao Ran
Li Tao
Yuxi Zhu
Yanwei Li
Chuan Zhang
Min Mao
Diansa Gao
Zhong Zuo
author_facet Zhulu Chen
Rui Lan
Tao Ran
Li Tao
Yuxi Zhu
Yanwei Li
Chuan Zhang
Min Mao
Diansa Gao
Zhong Zuo
author_sort Zhulu Chen
collection DOAJ
description Abstract This study aimed to find the association between four common clinical biomarkers and subsequent ICICT, developing a risk scoring strategy to assess the ICICT risk. Three terminals for ICICT were : Terminal 1, cancer therapy-related cardiomyopathies; Terminal 2, myocarditis or heart failure; and Terminal 3, myocarditis, heart failure, myocardial infarction, cerebral infarction, atrial fibrillation, or death. The thresholds were : N-terminal-pro-B-type-natriuretic-peptide ≥ 125 pg/mL, cardiac troponin T ≥ 6 ng/L, high-sensitivity C-reactive protein ≥ 3 mg/L, and coronary artery calcium score > 10 U. Each of the four abnormal biomarkers received 1 point. The links between biomarkers, score stage, and ICICT were analyzed. 375 patients with a mean follow-up of 1.91 years were included. All four biomarkers measured before immunotherapy were associated with a higher risk of developing ICICT. These scores were also associated with ICICT risk. The highest risk was the very high stage (score = 4) has 7.29, 8.83, and 7.02 folder higher risk compared to low risk group for Terminal 1–3, respectively. The cumulation of incidences also showed that the higher stages of score had an earlier onset and higher incidence of ICICT. 4 biomarkers and the scoring strategy enables clinicians to assess risk easily.
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spelling doaj-art-2a34aefbc29e47d08f40a1dde80f1dba2025-08-20T02:11:25ZengNature PortfolioScientific Reports2045-23222024-10-0114111010.1038/s41598-024-76829-5A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicityZhulu Chen0Rui Lan1Tao Ran2Li Tao3Yuxi Zhu4Yanwei Li5Chuan Zhang6Min Mao7Diansa Gao8Zhong Zuo9Department of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Clinical Nutrition, School of Medicine, Chongqing University Cancer Hospital, Chongqing UniversityDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Oncology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract This study aimed to find the association between four common clinical biomarkers and subsequent ICICT, developing a risk scoring strategy to assess the ICICT risk. Three terminals for ICICT were : Terminal 1, cancer therapy-related cardiomyopathies; Terminal 2, myocarditis or heart failure; and Terminal 3, myocarditis, heart failure, myocardial infarction, cerebral infarction, atrial fibrillation, or death. The thresholds were : N-terminal-pro-B-type-natriuretic-peptide ≥ 125 pg/mL, cardiac troponin T ≥ 6 ng/L, high-sensitivity C-reactive protein ≥ 3 mg/L, and coronary artery calcium score > 10 U. Each of the four abnormal biomarkers received 1 point. The links between biomarkers, score stage, and ICICT were analyzed. 375 patients with a mean follow-up of 1.91 years were included. All four biomarkers measured before immunotherapy were associated with a higher risk of developing ICICT. These scores were also associated with ICICT risk. The highest risk was the very high stage (score = 4) has 7.29, 8.83, and 7.02 folder higher risk compared to low risk group for Terminal 1–3, respectively. The cumulation of incidences also showed that the higher stages of score had an earlier onset and higher incidence of ICICT. 4 biomarkers and the scoring strategy enables clinicians to assess risk easily.https://doi.org/10.1038/s41598-024-76829-5Immune checkpoint inhibitorsCardiotoxicityMultimodality score strategyCardio-oncologyBiomarkers
spellingShingle Zhulu Chen
Rui Lan
Tao Ran
Li Tao
Yuxi Zhu
Yanwei Li
Chuan Zhang
Min Mao
Diansa Gao
Zhong Zuo
A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
Scientific Reports
Immune checkpoint inhibitors
Cardiotoxicity
Multimodality score strategy
Cardio-oncology
Biomarkers
title A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
title_full A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
title_fullStr A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
title_full_unstemmed A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
title_short A multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
title_sort multimodality score strategy for assessing the risk of immune checkpoint inhibitors related cardiotoxicity
topic Immune checkpoint inhibitors
Cardiotoxicity
Multimodality score strategy
Cardio-oncology
Biomarkers
url https://doi.org/10.1038/s41598-024-76829-5
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