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Immune checkpoint inhibitor myocarditis

Raikhelkar, Jayant; Uriel, Nir

Current Opinion in Cardiology: May 2019 - Volume 34 - Issue 3 - p 303–306
doi: 10.1097/HCO.0000000000000622
CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim

Purpose of review The purpose of this study is to summarize and highlight the recent literature regarding immune checkpoint inhibitor myocarditis.

Recent findings The use of immune checkpoint inhibitors, a promising form of immunotherapy, is rapidly increasing in oncology. These drugs have been recently found to cause a fulminant myocarditis associated with a high-case fatality rate. Most patients present early in the course of treatment with positive cardiac biomarkers. Endomyocardial biopsy findings resemble high-grade cardiac transplant rejection. Treatment requires cessation of immunotherapy, aggressive immunosuppression, and hemodynamic stabilization.

Summary Immune checkpoint inhibitor myocarditis is a newly described entity. Although relatively uncommon compared with other immune-related adverse events associated with these drugs, it is associated with the highest rate of mortality.

Division of Cardiology, University of Chicago, Chicago, Illinois, USA

Correspondence to Jayant Raikhelkar, MD, MC 2016, Rm A-621, 5841 S. Maryland Avenue, Chicago, IL 60637-1470, USA. Tel: +1 773 702 9396; e-mail:

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