Analysis of risk factors and establishment of prediction model for immune checkpoint inhibitor related myocarditis and major adverse cardiovascular events
10.3760/cma.j.cn112148-20231210-00489
- VernacularTitle:免疫检查点抑制剂相关心肌炎与主要不良心血管事件危险因素分析及预测模型的构建
- Author:
Rui LU
1
;
Jing LU
;
Yi LIAO
;
Wenjie LUO
;
Min WANG
;
Mingjun LU
Author Information
1. 广州医科大学附属第一医院心血管内科，广州 510120
- Keywords:
Myocarditis;
Immune checkpoint inhibitor;
Major adverse cardiovascular events;
Risk factors;
Nomogram;
Predictive model
- From:
Chinese Journal of Cardiology
2024;52(11):1290-1295
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the risk factors of major adverse cardiovascular events (MACEs) in immune checkpoint inhibitor (ICI) related myocarditis and establish a predictive model.Methods:This was a retrospective case-control study. Tumor patients diagnosed with ICI related myocarditis in the First Affiliated Hospital of Guangzhou Medical University from May 2019 to August 2023 were selected and divided into non-MACE group and MACE group based on whether MACE occurred. Clinical and imaging data of the two groups were collected. Univariate and multivariate logistic regression models were used to analyze the risk factors for MACE in patients with ICI related myocarditis. According to the results of multivariate logistic regression analysis, R 4.1.0 software was used to construct the MACE risk prediction model for these patients and draw a nomogram. The receiver operating characteristic curve was used to evaluate the prediction ability of the prediction model.Results:A total of 35 patients with ICI related myocarditis, aged (63.9±8.2) years, were included, including 28 males (80%). There were 18 patients in the non-MACE group and 17 patients in the MACE group. Multivariate logistic regression analysis showed that elevated neutrophil to lymphocyte ratio ( OR=1.115, 95% CI 1.007-1.235, P=0.036) and ST-T segment changes ( OR=24.942, 95% CI 1.239-502.194, P=0.036) were risk factors for MACE in patients with ICI related myocarditis. The receiver operating characteristic curve indicated that the area under the curve of the prediction model was 0.967 (95% CI 0.916-1.000, P<0.001), with a sensitivity of 88.2% and specificity of 100%, demonstrating good predictive ability. Conclusion:Elevated neutrophil to lymphocyte ratio and ST-T segment change are independent risk factors for MACE in patients with ICI related myocarditis. Risk prediction model based on the above two indicators can assist in the early identification and individualized intervention of ICI related myocarditis patients.
