Cardiovascular adverse events are associated with usage of immune checkpoint inhibitors in real-world clinical data across the United States.

BACKGROUND: Immune checkpoint inhibitors (ICIs) can cause life-threatening cardiovascular adverse events (CVAEs) that may not be attributed to therapy. The outcomes of clinical trials may underestimate treatment-related adverse events due to restrictive eligibility, limited sample size, and failure to anticipate selected toxicities. We evaluated the incidence and clinical determinants of CVAEs in real-world population on ICI therapy. PATIENTS AND METHODS: Among 2 687 301 patients diagnosed with cancer from 2011 to 2018, 16 574 received ICIs for any cancer. Patients in the ICI and non-ICI cohorts were matched in a 1 : 1 ratio according to age, sex, National Cancer Institute comorbidity score, and primary cancer. The non-ICI cohort was stratified into patients who received chemotherapy (N = 2875) or targeted agents (N = 4611). All CVAEs, non-cardiac immune-related adverse events occurring after treatment initiation, baseline comorbidities, and treatment details were identified and analyzed using diagnosis and billing codes. RESULTS: Median age was 61 and 65 years in the ICI and non-ICI cohorts, respectively (P < 0.001). ICI patients were predominantly male (P < 0.001). Lung cancer (43.1%), melanoma (30.4%), and renal cell carcinoma (9.9%) were the most common cancer types. CVAE diagnoses in our dataset by incidence proportion (ICI cohort) were stroke (4.6%), heart failure (3.5%), atrial fibrillation (2.1%), conduction disorders (1.5%), myocardial infarction (0.9%), myocarditis (0.05%), vasculitis (0.05%), and pericarditis (0.2%). Anti-cytotoxic T-lymphocyte-associated protein 4 increased the risk of heart failure [versus anti-programmed cell death protein 1; hazard ratio (HR), 1.9; 95% confidence interval (CI) 1.27-2.84] and stroke (HR, 1.7; 95% CI 1.3-2.22). Pneumonitis was associated with heart failure (HR, 2.61; 95% CI 1.23-5.52) and encephalitis with conduction disorders (HR, 4.35; 95% CI 1.6-11.87) in patients on ICIs. Advanced age, primary cancer, nephritis, and anti-cytotoxic T-lymphocyte-associated protein 4 therapy were commonly associated with CVAEs in the adjusted Cox proportional hazards model. CONCLUSIONS: Our findings underscore the importance of risk stratification and cardiovascular monitoring for patients on ICI therapy.

Multiplicative moiré two-beam phase-stepping and fourier-transform methods for the evaluation of multiple-beam fizeau patterns: a comparison.

A phase-evaluation method of multiple-beam Fizeau patterns that combines two-beam phase-stepping algorithms with the moiré effect was previously reported [Appl. Opt. 34, 3639-3643(1995)]. The method is based on a multiplicative moiréimage-formation process obtained by the direct superposition of high-frequency multiple-beam Fizeau carrier fringes upon a transmission grating (working as a phase modulator). We present a comparison between this multiplicative moiré two-beam phase-stepping method and the well-known Fourier-transform method for the topographic measurement of an undoped silicon wafer. The discrepancy between the two methods yields a rms phase-difference value of the order of(~2pi/90).

Transient Deformation Measurement by Double-Pulsed-Subtraction TV Holography and the Fourier Transform Method.

We report the measurement of transient bending waves with double-pulsed-subtraction TV holography. The correlation fringe patterns are automatically quantitatively analyzed by the application of Fourier methods. A novel optical setup with two different object-beam optical paths is demonstrated for the generation of carrier fringes. The proposed system is highly immune to environmental disturbances because the optical setup imposes no lower limit on the time separation between laser pulses. One removes the linear phase distribution due to the spatial carrier in the spatial domain by subtracting the phase of the undeformed carrier fringes from the phase of the modulated fringes. Experimental results obtained with an aluminum plate excited by the impact of a piezoelectric translator are presented.