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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardio-Oncology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1465743
This article is part of the Research Topic Targets in Cardio-Oncology: Drug Effects and Mechanisms of Action View all articles

Peripheral biomarkers to assess risk, severity, and prognosis of immune checkpoint inhibitor-associated myocarditis: A retrospective clinical study

Provisionally accepted
Zhengkun Guan Zhengkun Guan Tiezhu Yao Tiezhu Yao Guang Liu Guang Liu Jing Liu Jing Liu Ling Guo Ling Guo Zhenli Li Zhenli Li Jingtao Ma Jingtao Ma *
  • Fourth Hospital of Hebei Medical University, Shijiazhuang, China

The final, formatted version of the article will be published soon.

    Background: Immune checkpoint inhibitor-related myocarditis (ICI myocarditis) is an infrequent but potentially fatal immune-related adverse event. This study aimed to identify valuable indicators for risk prediction and evaluation of disease severity and outcomes. Methods: A total of 79 patients with severe or mild ICI myocarditis and 158 controls without post-ICI immune-related adverse events were enrolled in this retrospective study. The clinical application value of a series of simple biomarkers were tested. Results: Higher levels of the systemic immune-inflammation index (SII), neutrophilto-eosinophil ratio (NER), aspartate transferase-to-albumin ratio (AAR), and lactic dehydrogenase-to-albumin ratio (LAR) at myocarditis onset were associated with severe disease conditions. In the receiver operating characteristic analysis, biomarkers areas under the curve (AUC) close to or greater than 0.8 were LAR (AUC: 0.810) and AAR (AUC: 0.806). Patients with higher SII, AAR, and LAR also exhibited poorer overall survival. The SII, NER, AAR, and LAR before the last ICI treatment increased relative to baseline in patients with ICI myocarditis, whereas no significant changes in the tested biomarkers were observed in the control group. For SII, AAR, and LAR, high ratios of the biomarker levels before the last ICI to baseline was associated with the incidence of myocarditis. Conclusions: Surveillance of these economical biomarkers during ICI therapy might contribute to the risk prediction of ICI myocarditis, as well as the assessment of disease severity and prognosis.

    Keywords: immune-checkpoint inhibitor, cardiotoxicity, Myocarditis, biomarkers, risk, prognosis

    Received: 16 Jul 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Guan, Yao, Liu, Liu, Guo, Li and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jingtao Ma, Fourth Hospital of Hebei Medical University, Shijiazhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.