| Objective To investigate the incidence and characteristics of cardiac immune-related adverse events (irAEs) in patientstreated with various immune checkpoint inhibitors (ICIs), aiming to provide references for clinical drug safety.Methods A search was conducted in PubMed, Embase, CNKI, Wanfang, and VIP databases up to December 31, 2022. Literature screening was performedbased on inclusion criteria, and clinical data of patients with cardiac irAEs were collected and analyzed.Results A total of 184 arti. cles involving 230 cases were included. The highest proportion of ICIs-related cardiotoxicity was mainly found in myocardial diseases (148/230, 64.35%). The overall median onset time for ICI-related cardiac toxicity was 4.00 weeks. The median onset time for cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor-related cardiac toxicity was 11.07 weeks, which was later than that for pro. grammed cell death protein-1 (PD-1) inhibitors (3.64 weeks, H=7.71, P=0.033) and combination therapy (2.86 weeks, H=10.14, P= 0.009). In cases of ICIs-related cardiotoxicity, 68.94% (159/230) showed improvement after treatment, while 29.79% (68/230) died.Compared with patients who received ipilimumab alone, patients who received both ipilimumab and nivolumab experienced earlier on.set of cardiotoxicity (2.79 weeks vs. 12.00 weeks, H=9.58, P=0.002), but no significant difference in mortality was observed (34.38% vs. 31.25%, χ2=0.05, P=0.829). Conclusions ICI-related cardiac toxicity has the characteristics of diverse types, early onset, atypicalclinical manifestations, and high mortality, which should be concerned clinically. Furthermore, the onset time, type, and outcomes ofcardiac toxicity vary with different ICIs, and tailored strategies should be employed. |
