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JACC May 11, 2021

Volume 77, Issue 18

Spotlight on Special Topics

CARDIOVASCULAR ADVERSE EVENTS ASSOCIATED WITH NIVOLUMAB VERSUS STANDARD
CHEMOTHERAPY IN PATIENTS WITH CANCER. A META-ANALYSIS OF RAMDOMIZED CONTROL
TRIALS
Poster Contributions
Sunday, May 16, 2021, 2:45 p.m.-3:30 p.m.

Session Title: Spotlight on Special Topics: Cardio-Oncology 6

Abstract Category: 57. Spotlight on Special Topics: Cardio-oncology

Authors: Eder Cativo Calderon, Nehemias Guevara, Noemy Coreas, Persio Lopez Loyo, Diana P. Cativo, Hasitha Manohar, Anurag
Gaddam, Steven Atlas, Clive Rosendorff, James J Peters Bronx VA Medical Center/ Icahn School of Medicine Mount Sinai, New York, NY,
USA, Universidad de El Salvador, El Salvador
Background: The monoclonal antibody nivolumab, an immunomodulatory antibody used to enhance the immune system, has
substantially improved the prognosis for patients with advanced malignancy. However, life-threatening cardiovascular adverse
effects could limit its use and may warrant specific follow-up strategies.
Methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Control Trials, and ClinicalTrials.gov (www.
clinicaltrials.gov) database to identify randomized clinical trials evaluating the use of nivolumab versus standard chemotherapy. The
data were expressed as the risk ratios (RRs) and 95% CIs for dichotomous outcomes. For the analysis, we used the fixed-effect
model.
Results: We included 8 RCT (n=3759). The use of Nivolumab was associated with an increased risk of arterial hypertension events
in patients receiving this therapy compared with controls ( RR 1.85; 95% CI 1.27-2.71 p=0.001 (I2=0%; p=0.43). There was no
statistically-significant relationship between nivolumab and neither cardiac nor cerebral ischemic events.
Conclusion: This study provides high-quality evidence demonstrating that nivolumab increases the risk of arterial hypertension.
Moreover, nivolumab is not associated with an increased risk of cardiac or cerebral ischemic events