Cardio-oncology & otherCohort study
Chimeric antigen receptor T-cell therapy and cardiovascular outcomes in US Medicare beneficiaries
- Retrospective cohort study
- national Medicare claims
Authors' conclusion
In the largest national sample of older adults receiving CAR-T, MACE occurred in 5.8% of patients and were associated with increased in-hospital and 1-year mortality.
Study context
- Population
- Medicare fee-for-service beneficiaries over 65 receiving inpatient CAR-T therapy, 2018–2023
- Participants
- 3,292 participants
- Outcome
- Incidence of MACE:
- Acute HF
- Cardiogenic shock
- MI
- Cardiac tamponade
- Ventricular arrhythmia
- Complete heart block
- Stroke
Main finding
As reported in the abstract
MACE
CAR-T
5.8%
191 events
Observational data: associations, not effects.
Further findings
Most common major adverse cardiovascular events (MACE) components
- Acute heart failure (HF)
- 3.1%
- Ischaemic stroke
- 1.3%
- Haemorrhagic stroke
- 1%
Pre-treatment risk factors independently associated with MACE
- AF/flutter, aOR
- 1.52 (1.08-2.16)
- Cardiomyopathy, aOR
- 2.49 (1.75-3.54)
- Cerebrovascular disease, aOR
- 2.40 (1.30-4.43)
MACE in 2021-23 associated with immune effector cell-associated neurotoxicity syndrome and higher-grade cytokine release syndrome
- MACE also associated with immune effector cell-associated neurotoxicity syndrome and higher-grade cytokine release syndrome
Mortality associated with MACE
- In-hospital mortality, aOR
- 16.9 (11.0-26.1)
- 1-year mortality after discharge, adjusted HR
- 1.91 (1.46-2.49)
Original publication
Chimeric antigen receptor T-cell therapy and cardiovascular outcomes in US Medicare beneficiaries. Eur Heart J. Published 26 May 2026. doi:10.1093/eurheartj/ehag394
Summarised from the published abstract; every number is checked against it