{"id":"60a6c3ee1e51","type":"article","url":"https://hartvaat.nl/2026/05/08/car-t-therapie-en-cardiovasculaire-uitkomsten-in-duitsland-en-vs-ernstige-events/","title":"CAR-T-therapie en cardiovasculaire uitkomsten in Duitsland en VS: ernstige events zeldzaam acuut, hoger op lange termijn bij pre-existente hartziekte","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","farmaco-economie","select-trial","vrouwen"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag132","source_url":"https://doi.org/10.1093/eschf/xvag132","authors":["Jakob Christoph Voran","Lars Fransecky","Hatim Seoudy","Manuel Hecht","Oliver Müller","Philipp Berning","Alexander Pohlmann","Cornelia Baden","Tim Versteegen","Claudia D Baldus","Friedrich Stölzel","Derk Frank","David Baden"],"significance":7,"published":"2026-06-26","source_date":"2026-05-08","image":"","kennis":[],"congress":"","summary_en":"Analysis of two independent CAR-T cell therapy registries: 2,545 German patients (DESTATIS) and 1,335 US patients (TriNetX). Acutely severe cardiac events were relatively rare (51 and 20 cases respectively); 5% of German and 1.2% of US patients died shortly after CAR-T. Patients with pre-existing cardiac disease had no increased risk for immune-mediated complications (cytokine release syndrome OR 1.19; neurotoxicity OR 1.59) but higher long-term risk for major cardiovascular events (OR 1.89; 95% CI 1.23-2.91) and kidney failure (OR 2.98; 95% CI 1.85-4.81). The cumulative evidence underscores the need for risk-adapted follow-up and cardiological assessment in CAR-T patients with cardiac comorbidity. Interpretation is subject to potential under- and over-reporting in registries.","created":"2026-07-03T10:33:07Z","updated":"2026-07-03T13:32:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse van twee onafhankelijke registers van CAR-T-celtherapie: 2.545 Duitse patiënten (DESTATIS) en 1.335 Amerikaanse patiënten (TriNetX). Acuut ernstige cardiale events kwamen relatief zelden voor (51 respectievelijk 20 cases); 5% van de Duitse en 1,2% van de Amerikaanse patiënten overleed kort na CAR-T. Patiënten met pre-existente hartziekte hadden geen verhoogd risico op immuun-gemedieerde complicaties (cytokine release syndrome OR 1,19; neurotoxiciteit OR 1,59) maar wel op major cardiovascular events op langere termijn (OR 1,89; 95%-BI 1,23-2,91) en nierfalen (OR 2,98; 95%-BI 1,85-4,81). De cumulatieve evidence onderstreept het belang van risicogerichte follow-up en cardiologische beoordeling bij CAR-T-patiënten met cardiale comorbiditeit. Interpretatie is onder voorbehoud van mogelijke onder- en overrapportage in registers.","abstract_original":"AIMS: CAR-T cell therapy is becoming a key pillar of medical oncology, used for an expanding range of indications. Considering the increased risk of cardiovascular disease with increasing age, assessing the impact of cardiac comorbidities can help minimizing complications and improve treatment outcomes. METHODS: We evaluated cardiovascular outcomes in patients undergoing CD19- or BCMA-directed CAR T-cell therapy from two large independent databases (DESTATIS (Germany) and the TriNetX network (US)). RESULTS: Among 2,545 CAR T-cell cases from Germany and 1,335 patients from the US, we identified 51 respective 20 short-term severe cardiac events with early death documented in 135 (5%) and 16 (1.2%) patients. Patients with preexisting cardiac conditions did not show an increased risk for immune-related complications like cytokine release (OR 1.19, 95%CI 0.77-1.82) or neurotoxicity syndrome (OR 1.59, 95%CI 0.94-2.69). They faced higher long-term risks for major cardiovascular events (OR 1.89, 95%CI 1.23-2.91) and kidney failure (OR 2.98, 95%CI 1.85-4.81). CONCLUSION: Cardiovascular complications in CAR T-cell therapy were rare and primarily affected patients with preexisting cardiac conditions. Serious cardiac events were uncommon acutely but increased over time. The analysis underscores the need for risk-adapted follow-up and cardiological assessments to improve outcomes in patients with cardiac comorbidities. Inherent with the databases used, these results should be interpreted with caution, as underreporting and overreporting could introduce bias regarding risik factors and outcomes in both directions."}