• side effects of drugs
• chemotherapy
• cardiology
• therapeutic drug monitoring
• hospital pharmacy competencies

Decades ago, cancer patients were treated in cardiology consultations due to unexpected adverse effects arising from the use of traditional chemotherapy that had not been anticipated. Recently, Ball et al reviewed the cardiotoxicity associated with treatments with immune checkpoint inhibitors (ICIs). Their work was published on 1 October 2019 in the review topic of the week in the Journal of the American College of Cardiology.1 The publication described the cardiovascular adverse events associated with exposure to ICIs based on the literature of the last few years. The authors carried out a complete review, expanding the results and perspectives obtained from clinical trials to include the real-life results of patients.

Myocarditis is the most common adverse cardiovascular event associated with ICIs (45%), with a rate of fulminant myocarditis of 15%. The mortality rate is 50%, while the mortality rate associated with pericardial disease or vasculitis is 21% and 6%, respectively. Takosubo syndrome, arrhythmias and vasculitis are other important cardiovascular events.1 Despite being uncommon, they are also serious adverse events.

Most adverse events with ICIs occur within the first 4 months of treatment, but cardiovascular events can occur at any time during treatment or …

Correspondence to Raquel Moreno Diaz, Pharmacy, Hospital Universitario Infanta Cristina, Parla 28981, Spain; rmorenod{at}salud.madrid.org