Cardiovascular complications of patients receiving CAR-T therapy.

Abstract

e24019 Background: While highly effective for certain cancers, chimeric antigen receptor T-cell (CAR-T) therapy can lead to cardiovascular complications, including arrhythmias, heart failure, and vascular events. These arise primarily from cytokine release syndrome (CRS) and immune activation, which increase inflammatory responses and place significant stress on the cardiovascular system, posing risks for vulnerable patients. We aimed to investigate the cardiovascular complications in patients undergoing CAR-T therapy and assess their impact on overall mortality. Methods: We utilized the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) to identify cancer patients diagnosed who had received CAR-T therapy from 2016 to 2020. Our analysis focused on cardiovascular complications and mortality from these complications in these hospitalized patients. We employed multivariable logistic and linear regression models to assess the outcomes, calculating adjusted odds ratios. Statistical significance was set at a p-value of <0.05. Results: We found a total of 5195 patients who received CAR-T therapy who were admitted from the year 2016 to 2020. Out of them, 235 patients were found to have congestive heart failure, 385 patients were hospitalized with acute coronary syndrome, 255 patients with ventricular arrhythmias, and 349 patients with atrial fibrillation. In contrast,19 patients had a cardiac arrest (p-value <0.001). The mortality of the patients who died from congestive heart failure was (0.085%, n=19, aOR 3.3, p-value 0.02), with acute coronary syndrome 0.025%, (n=10 patients, aOR 0.8, p-value 0.8), with atrial fibrillation was 0.14% (n=49 patients, aOR 9.1, p-value <0.001), with ventricular arrhythmia was 0.13% (n=35, aOR n5.2, p-value 0.001), and with cardiac arrest mortality was 73% (n=14, aOR 81, p-value<0.001). Conclusions: In patients undergoing CAR-T therapy, cardiovascular complications such as congestive heart failure, acute coronary syndrome, ventricular arrhythmias, and atrial fibrillation were significant, with notable impacts on mortality. These findings highlight the need for vigilant cardiovascular monitoring and management in CAR-T therapy patients to improve outcomes.