Role of Biomarkers in the Management of Immune-Checkpoint Inhibitor-Related Myocarditis

Alexi Vasbinder, Anis Ismail, Joe Elie Salem, Salim S. Hayek

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Immune 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 Findings: Myocardial 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. Summary: Biomarkers, such as cardiac troponins and creatine phosphokinase, can be used in combination in the monitoring, diagnosis, and prognostication of patients with ICI-related myocarditis.

Original languageEnglish (US)
Pages (from-to)959-967
Number of pages9
JournalCurrent Cardiology Reports
Volume25
Issue number9
DOIs
StatePublished - Sep 2023
Externally publishedYes

Keywords

  • BNP
  • CPK
  • ICI
  • irAE
  • Myositis
  • Troponin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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