Immune Checkpoint Inhibitor Myocarditis and Left Ventricular Systolic Dysfunction

doi:10.1016/j.jaccao.2025.01.020

Immune Checkpoint Inhibitor Myocarditis and Left Ventricular Systolic Dysfunction

JACC CardioOncolPublication date not resolved

Retrospective cohort study
international
multicentre
registry

Authors' conclusion

Dyspnea, time from ICI initiation, a history of heart failure, and prior cardiotoxic therapy may be predictors of an initial LVEF <50% in patients with ICI-M.

Study context

Population: Patients hospitalized with immune checkpoint inhibitor myocarditis (International ICI-Myocarditis Registry)707 with documented left ventricular ejection fraction (LVEF)
Participants: 757 patients

Exposure: LVEF <50% vs LVEF ≥50% on admission
LVEF <50%n = 244
LVEF ≥50%n = 463reference
Outcome: Factors associated with LVEF <50% vs ≥50% at hospitalization for ICI myocarditis
Follow-up: At hospitalization

Main finding

As reported in the abstract

Factors associated with LVEF <50%

Prior chest radiation

P < 0.001

LVEF <50%24.2%

LVEF ≥50%13.5%

Observational data: associations, not effects.

Secondary outcomes

Outcome	Lower risk with LVEF <50% ←→ Higher risk with LVEF <50%	HR (95% CI)
30-day all-cause mortality · marginally associated		1.50 (1.02–2.20)
	0.512Hazard ratio (log scale)

30-day all-cause mortality: adjusted for age, cancer types and ICI therapy; unadjusted log-rank P = 0.062

Original publication

Immune Checkpoint Inhibitor Myocarditis and Left Ventricular Systolic Dysfunction. JACC CardioOncol. doi:10.1016/j.jaccao.2025.01.020

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Summarised from the published abstract; every number is checked against it