Table 4.
OR of baseline characteristics of patients who developed pericardial disease while on an ICI and age-type and cancer-type matched patients who did not develop pericardial disease while on an ICI
| Those who developed pericardial disease | Those who did not develop pericardial disease | OR | P value | |||
| Demographic, no (%) | ||||||
| Number of patients | 42 | 84 | ||||
| Male | 20 | 47.6 | 40 | 47.6 | 1.00 (0.48 to 2.10) | 1.00 |
| Age >65 | 20 | 47.6 | 40 | 47.6 | 1.00 (0.48 to 2.10) | 1.00 |
| Overweight (BMI 25–29.9) | 9 | 21.4 | 27 | 32.1 | 0.58 (0.24 to 1.37) | 0.21 |
| Obesity (BMI ≥30) | 8 | 19.1 | 13 | 15.5 | 1.29 (0.49 to 3.39) | 0.61 |
| Race or ethnic group, no (%) | ||||||
| White | 37 | 88.10 | 76 | 90.48 | 0.78 (0.24 to 2.55) | 0.68 |
| Asian | 5 | 11.90 | 2 | 2.38 | 5.54 (1.03 to 29.88) | 0.046 |
| Black or African American | 0 | 0.00 | 3 | 3.57 | N/A | |
| Hispanic | 0 | 0.00 | 0 | 0.00 | N/A | |
| Other | 0 | 0.00 | 1 | 1.19 | N/A | |
| Clinical variables, mean (SD) | ||||||
| BMI (kg/m2) | 26.61 | 4.48 | 26.24 | 4.80 | N/A | |
| Systolic blood pressure (mm Hg) | 124.43 | 13.33 | 130.44 | 19.54 | N/A | |
| Diastolic blood pressure (mm Hg) | 75.59 | 7.02 | 75.77 | 9.29 | N/A | |
| Cardiovascular risk factors, no (%) | ||||||
| Hypertension | 22 | 52.38 | 41 | 48.81 | 1.15 (0.55 to 2.42) | 0.71 |
| Diabetes mellitus | 4 | 9.52 | 17 | 20.24 | 0.42 (0.13 to 1.32) | 0.14 |
| Smoking current or prior | 6 | 14.29 | 22 | 26.19 | 0.47 (0.17 to 1.27) | 0.14 |
| Hyperlipidemia | 1 | 2.38 | 1 | 1.19 | 2.02 (0.12 to 33.19) | 0.62 |
| Cardiovascular diagnoses, no (%) | ||||||
| History of any cardiovascular event | 1 | 2.38 | 8 | 9.52 | 0.23 (0.028 to 1.928) | 0.18 |
| History of myocardial infarction | 0 | 0 | 6 | 7.14 | N/A | |
| History of coronary revascularization (PCI) | 1 | 2.38 | 4 | 4.76 | 1.17 (0.094 to 14.52) | 0.90 |
| History of ischemic stroke | 0 | 0.00 | 2 | 2.38 | N/A | |
| Cardiovascular medications, no (%) | ||||||
| ACE inhibitor or angiotensin II receptor blocker | 11 | 26.19 | 22 | 26.19 | 1.00 (0.43 to 2.32) | 1.00 |
| Beta blockers | 11 | 26.19 | 15 | 17.86 | 1.63 (0.67 to 3.96) | 0.28 |
| Calcium channel blockers | 3 | 7.14 | 9 | 10.71 | 0.64 (0.16 to 2.51) | 0.52 |
| Statins | 14 | 33.33 | 28 | 33.33 | 1.00 (0.46 to 2.19) | 1.00 |
| Diuretics | 11 | 26.19 | 25 | 29.76 | 0.84 (0.36 to 1.92) | 0.68 |
| Aspirin | 9 | 21.43 | 16 | 19.05 | 1.16 (0.46 to 2.90) | 0.75 |
| Other anti-platelet therapies | 0 | 0 | 2 | 2.38 | N/A | |
| Other medical comorbidities, no (%) | ||||||
| Chronic kidney disease | 6 | 14.29 | 9 | 10.71 | 1.39 (0.46 to 4.20) | 0.56 |
| Cancer types, no (%) | ||||||
| Lung | 27 | 64.29 | 57 | 67.86 | 0.85 (0.39 to 1.86) | 0.68 |
| Melanoma | 8 | 19.05 | 16 | 19.05 | 1.00 (0.39 to 2.57) | 1.00 |
| Head and neck | 2 | 4.76 | 4 | 4.76 | 1.00 (0.18 to 5.59) | 1.00 |
| Renal and genitourinary | 0 | 0 | 0 | 0 | N/A | |
| Breast | 1 | 2.38 | 0 | 0 | N/A | |
| Gastrointestinal | 0 | 0 | 0 | 0 | N/A | |
| Gynecologic | 2 | 4.76 | 4 | 4.76 | 1.00 (0.18 to 5.69) | 1.00 |
| Hepatobiliary | 0 | 0 | 1 | 1.19 | N/A | |
| Lymphoma | 0 | 0 | 0 | 0 | N/A | |
| Other | 2 | 4.76 | 2 | 2.38 | 2.05 (0.28 to 15.09) | 0.48 |
| Prior potentially cardiotoxic cancer therapies, no (%) | ||||||
| Radiation therapy | 6 | 14.29 | 13 | 15.48 | 0.91 (0.312 to 2.59) | 0.51 |
| 5-fluorouracil | 1 | 2.38 | 2 | 2.38 | 1.00 (0.088 to 11.35) | 1.00 |
| Anthracyclines | 0 | 0 | 0 | 0 | N/A | |
| Tyrosine kinase inhibitors | 1 | 2.38 | 1 | 1.19 | 2.02 (0.12 to 33.19) | 0.62 |
| Platinum-based therapy | 19 | 45.24 | 38 | 45.24 | 1.00 (0.48 to 2.11) | 1.00 |
| ICI type, no (%) | ||||||
| Programmed death-ligand 1 | 5 | 11.90 | 9 | 10.71 | 1.12 (0.35 to 3.60) | 0.84 |
| Cytotoxic-T lymphocyte-associated protein 4 | 2 | 4.76 | 4 | 4.76 | 1.00 (0.17 to 5.69) | 1.00 |
| Programmed death protein 1 | 33 | 78.57 | 66 | 78.57 | 1.00 (0.41 to 2.47) | 1.00 |
| Cytotoxic-T lymphocyte-associated protein 4 or programmed death protein 1 | 0 | 0 | 0 | 0 | N/A | |
| Combination therapy | ||||||
| Cytotoxic-T lymphocyte-associated protein 4/programmed death protein 1 | 2 | 4.76 | 5 | 5.95 | 1.54 (0.33 to 7.21) | 0.58 |
| Number of cycles of ICI, no (IQR) | 5 | (2–10) | 5 | (3–10) | N/A | |
| Greater than 5 cycles of treatment | 15 | 35.7 | 27 | 32.1 | 1.17 (0.54 to 2.56) | 0.68 |
| Immune-mediated adverse events after ICI start, no (%) | ||||||
| Gastrointestinal | 4 | 9.52 | 16 | 19.05 | 0.45 (0.14 to 1.44) | 0.18 |
| Skin | 7 | 16.67 | 8 | 9.52 | 1.90 (0.638 to 5.65) | 0.25 |
| Pulmonary | 6 | 14.29 | 6 | 7.14 | 2.17 (0.65 to 7.18) | 0.31 |
| Hepatic | 2 | 4.76 | 5 | 5.95 | 0.79 (0.15 to 4.25) | 0.78 |
| Endocrine | 5 | 11.90 | 4 | 4.76 | 2.70 (0.69 to 10.64) | 0.16 |
| Renal | 3 | 7.14 | 4 | 4.76 | 1.54 (0.33 to 7.21) | 0.51 |
| Neuromuscular | 1 | 2.38 | 0 | 0 | N/A | |
| Pancreas | 1 | 2.38 | 3 | 3.57 | 0.66 (0.066 to 6.53) | 0.72 |
| Any of the above adverse events | 22 | 52.38 | 34 | 40.28 | 1.618 (0.767 to 3.41) | 0.21 |
| Immune-mediated adverse events treated with corticosteroids, no (%) | ||||||
| Baseline corticosteroids (prior to ICI) | 7 | 16.67 | 5 | 5.96 | 3.16 (0.94 to 10.65) | 0.06 |
| Among those with immune-mediated adverse events | 14 | 33.33 | 17 | 20.24 | 1.97 (0.86 to 4.54) | 0.11 |
ACE, angiotensin-converting enzyme; BMI, body mass index; ICI, immune checkpoint inhibitor; N/A, not available; PCI, percutaneous coronary intervention.