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. 2023 Apr 18;12(8):e029211.
doi: 10.1161/JAHA.122.029211. Epub 2023 Apr 12.

Diagnostic Value of the International Society of Cardio-Oncology Definition for Suspected Immune Checkpoint Inhibitor-Associated Myocarditis

Francois Deharo  1 , Franck Thuny  2 , Farah Cadour  2 , Noemie Resseguier  3 , Alexandra Meilhac  1 , Melanie Gaubert  1 , Charles Dolladille  4   5 , Franck Paganelli  1 , Joachim Alexandre  4   5 , Jennifer Cautela  1
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Diagnostic Value of the International Society of Cardio-Oncology Definition for Suspected Immune Checkpoint Inhibitor-Associated Myocarditis

Francois Deharo et al. J Am Heart Assoc. .

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Keywords: cancer; cardio‐oncology; diagnosis; immunotherapy; myocarditis.

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Figures

Figure .
Figure .. Study flowchart (A) and key results (B).
*Patients were excluded in case of infectious myocarditis (since the knowledge of COVID‐19, all patients were tested for COVID‐19 and were negative), acute coronary syndrome confirmed by an acute coronary artery occlusion during angiography, and if CMR could not be performed (because of contraindications, claustrophobia, and image artifact). †To establish this diagnosis, the experts used the recommendations and consensus on myocarditis, and a consensus report specific to myocarditis induced by cancer therapies. ‡Of the 11 patients with asymptomatic isolated cTn elevation, 4 patients had coronary artery disease, and 7 patients did not have coronary artery disease. §Diagnosis was based on cTn elevation with 1 major criterion (modified L‐L Criteria 2/2) or 2 minor criteria among clinical syndromes, decline in cardiac function, ventricular arrhythmia and/or new conduction system disease, other immune‐related adverse events, or suggestive magnetic resonance imaging (modified L‐L criteria 1/2). ACS indicates acute coronary syndrome; CMR, cardiac magnetic resonance; cTn, cardiac troponin; ICI, immune checkpoint inhibitor; ICI‐M, immune checkpoint inhibitor‐associated myocarditis; IC‐OS, International Cardio‐Oncology Society; and Minoca, myocardial infarction with no obstructive coronary artery disease.
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