Acute Coronary Syndrome With Immune Checkpoint Inhibitors: A Proof-of-Concept Case and Pharmacovigilance Analysis of a Life-Threatening Adverse Event

Can J Cardiol. 2020 Apr;36(4):476-481. doi: 10.1016/j.cjca.2019.11.035. Epub 2019 Dec 11.

Abstract

Isolated cases of acute coronary syndrome (ACS) associated with immune checkpoint inhibitors (ICIs) have been described without the establishment of a formal cause-and-effect relationship between treatment and adverse event. We reported a case of ACS after the first administration of an ICI and with a fatal recurrence in another coronary area immediately after readministration. According to guidelines, causality was considered to be certain. Subsequently, we queried the French pharmacovigilance database and found 4 cases of ACS with coronary artery thrombosis. Causality was probable in those patients. These data suggest that ACS may be another life-threatening cardiac adverse event occurring with ICI exposure.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / chemically induced*
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / adverse effects*
  • Female
  • Humans
  • Immunologic Factors / adverse effects*
  • Male
  • Middle Aged
  • Pharmacovigilance*
  • Proof of Concept Study

Substances

  • Antineoplastic Agents, Immunological
  • Immunologic Factors