Role of Biomarkers in the Management of Immune-Checkpoint Inhibitor-Related Myocarditis.
Role of Biomarkers in the Management of Immune-Checkpoint Inhibitor-Related Myocarditis.
复制标题
生物标志物在免疫检查点抑制剂相关心肌炎治疗中的作用。
DOI：
10.1007/s11886-023-01915-5
复制
发表时间：
2023
影响因子：
3.7
通讯作者：
Hayek,SalimS
中科院分区：
文献类型：
--
作者：
Vasbinder,Alexi;Ismail,Anis;Salem,Joe-Elie;Hayek,SalimS
综述目的免疫检查点抑制剂（ICI）相关心肌炎因其非特异性表现、快速进展和高死亡率而构成重大临床挑战。在这里，我们回顾了血液生物标志物在 ICI 相关心肌炎患者临床管理中的作用。最新发现心肌损伤、其独特的模式以及与肌炎的共存是 ICI 相关心肌炎的定义特征。非心脏生物标志物，特别是肌酐磷酸激酶，出现在症状出现之前，并且对于诊断 ICI 相关心肌炎高度敏感，使其成为有用的筛查生物标志物。心肌肌钙蛋白和非心脏生物标志物的联合升高提高了 ICI 心肌炎诊断的可信度。高肌钙蛋白和肌酐磷酸激酶水平与严重后果密切相关。我们提出了基于生物标志物的算法来监测和诊断 ICI 相关心肌炎。摘要生物标志物，如心肌肌钙蛋白和肌酸磷酸激酶，可联合用于 ICI 相关心肌炎患者的监测、诊断和预后。
Purpose of ReviewImmune checkpoint inhibitor (ICI)-related myocarditis poses a major clinical challenge given its non-specific presentation, rapid progression, and high mortality rate. Here, we review the role of blood-based biomarkers in the clinical management of patients with ICI-related myocarditis.Recent FindingsMyocardial injury, its unique pattern, and the co-occurrence with myositis are defining features of ICI-related myocarditis. Non-cardiac biomarkers, specifically creatinine phosphokinase, precedes the symptomatic presentation and is highly sensitive for diagnosing ICI-related myocarditis, making them useful screening biomarkers. Combined elevations in cardiac troponins and non-cardiac biomarkers improve the confidence of an ICI myocarditis diagnosis. High troponin and creatinine phosphokinase levels are strongly associated with severe outcomes. We propose biomarker-based algorithms for the monitoring and diagnosis of ICI-related myocarditis.SummaryBiomarkers, such as cardiac troponins and creatine phosphokinase, can be used in combination in the monitoring, diagnosis, and prognostication of patients with ICI-related myocarditis.