Author + information
- Received November 1, 2017
- Revision received November 26, 2017
- Accepted November 30, 2017
- Published online August 6, 2018.
- Stephane Ederhy, MDa,b,
- Jennifer Cautela, MDc,d,e,
- Yann Ancedy, MDa,b,
- Marion Escudier, MDc,d,e,
- Franck Thuny, MD, PhDc,d,e and
- Ariel Cohen, MD, PhDa,b,∗ ()
- aDepartment of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Saint Antoine, Paris, France
- bINSERM U 856, Thrombose, Athérothrombose et Pharmacologie Appliquée, Paris, France
- cUnit of Heart Failure and Valve Heart Diseases, Department of Cardiology, Nord Hospital, Marseille, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Mediterranean University Cardio-Oncology Center, France
- dMediterranean Association for Studies in Cardiology, France
- eOncosaftey Network of the Early Phases Cancer Trials Center, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- ↵∗Address for correspondence:
Prof. Ariel Cohen, Assistance Publique-Hôpitaux de Paris, Hôpital Saint Antoine, Department of Cardiology, Paris, France, 184 rue du Faubourg saint Antoine, Paris 75012, France.
Takotsubo syndrome (TTS) is defined as an acute, reversible, left ventricular (LV) systolic dysfunction that can mimic acute coronary syndrome. In patients with TTS, the prevalence of patients with a history of cancer can be as high as 29% (1). Several drugs and particularly chemotherapy are associated with the risk of developing TTS, including molecule-targeted agents (axitinib, sunitinib, and bevacizumab), trastuzumab, and fluorouracil (5-FU). Immune checkpoint inhibitors (ICIs) have improved the management and the prognosis of several cancer types. By reactivating immune response against tumor cells, the administration of ICIs could lead to immune-related adverse events. Myocarditis is the main clinical manifestation of ICI-related cardiotoxicity, with an incidence varying from 0.09% to 0.27% (2). Although the incidence seems low, the mortality is high because almost 50% of patients who develop myocarditis die. We report here 2 cases of TTS as new manifestation of cardiotoxicity related to ICI administration (Figures 1 and 2, Online Videos 1, 2, 3, 4, 5, 6, 7, and 8).
Dr. Ederhy has received consultant and lecture fees from Amgen, Bayer Pharma, Bristol-Myers Squibb, Celgene, Daiichi-Sankyo, Lilly, Jansen Cilag, and Novartis. Dr. Thuny has received consultant and lecture fees from AstraZeneca, Novartis, Sanofi, Boston Scientific, and Bristol-Myers Squibb. Prof. Cohen has received a research grant from RESICARD (research nurses); and has received consultant and lecture fees from AstraZeneca, Bayer Pharma, Boehringer Ingelheim, Daiichi-Sankyo, GlaxoSmithKline, and Sanofi. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 1, 2017.
- Revision received November 26, 2017.
- Accepted November 30, 2017.
- 2018 American College of Cardiology Foundation