Myocardial Expression of PD-L1 as a Marker of Poor Prognosis in Immune Checkpoint Inhibitor–Associated Myocarditis

doi:10.1016/j.jaccao.2026.03.006

Myocardial Expression of PD-L1 as a Marker of Poor Prognosis in Immune Checkpoint Inhibitor–Associated Myocarditis

JACC CardioOncolPublication date not resolved

Cohort study
consecutive cases
biopsy-proven

Authors' conclusion

High myocardial PD-L1 expression is associated with greater disease severity and a higher risk of major adverse cardiotoxic events in ICI-associated myocarditis.

Study context

Population: Patients with biopsy-proven immune checkpoint inhibitor–associated myocarditis
Participants: 20 consecutive cases

Exposure: High vs low myocardial PD-L1 expression
High PD-L1n = 7
Low PD-L1n = 13reference
Outcome: Major adverse cardiotoxic events:
Severe HF
Severe arrhythmia
Cardiac death
Follow-up: 30 days

Main finding

As reported in the abstract

30-day major adverse cardiotoxic events

High PD-L171.4%5 of 7

Low PD-L17.7%1 of 13

P = 0.007

Observational data: associations, not effects.

Further findings

QRS duration on ECG

P = 0.021

High PD-L1124 msIQR 108-131 ms

Low PD-L196 msIQR 90-102 ms

Outcome	High PD-L1	Low PD-L1	P value
Peak normalized troponin (× upper limit of normal)	median 662 (IQR 204–855)	median 64 (IQR 26–108)	P = 0.010
CD3+ T cell infiltration	35.9% (IQR 25.8%–42.8%)	2.6% (IQR 0.6%–5.8%)	P = 0.007
CD68+ macrophage infiltration	15.2% (IQR 10.2%–21.1%)	1.23% (IQR 0.4%–2.3%)	P = 0.007

Original publication

Myocardial Expression of PD-L1 as a Marker of Poor Prognosis in Immune Checkpoint Inhibitor–Associated Myocarditis. JACC CardioOncol. doi:10.1016/j.jaccao.2026.03.006

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