Risk factors of immune checkpoint inhibitor-related cardiotoxicity: a scoping review.

BACKGROUND

Cardiotoxicity due to immune checkpoint inhibitors (ICIs) is not a common phenomenon but can lead to fatal outcomes in cancer patients. The clinical manifestations of this cardiotoxicity are also nonspecific and difficult to identify promptly. Hence, the study aimed to define the risk factors of ICI-related cardiotoxicity to enable early identification of high-risk groups and implement timely intervention for patients receiving ICI therapy.

MATERIALS AND METHODS

A scoping review was conducted using the methodological framework of Arksey and O'Malley. We performed a systematic literature search of ten electronic databases, including PubMed, Web of Science Core Collection, Embase, ProQuest, Scopus, CINAHL, CNKI, SinoMed, Wanfang, and VIP, for relevant articles on this topic. The literature and the obtained data were screened and extracted independently by two reviewers. This review is reported in accordance with PRISMA-ScR guidelines.

RESULTS

We identified 29 published studies and 60 risk factors of ICI-related cardiotoxicity in this scoping review. In addition to 25 common risk factors of immune-related adverse events and 5 traditional cardiovascular disease-associated risk factors, we also found 30 specific risk factors of ICI-related cardiotoxicity, including cardiovascular medical history, renal disease, obstructive sleep apnea, abnormalities in laboratory parameters, and cardiovascular medications.

CONCLUSIONS

Based on this scoping review, we provided a comprehensive list of 3 areas that included 60 risk factors of ICI-related cardiotoxicity and discussed the potential underlying mechanisms. This review could enable clinicians to identify high-risk patients for the timely prevention and treatment of ICI-related cardiotoxicity and further improve their outcomes.