To evaluate sex-based differences in major adverse cardiovascular events (MACE) and cardiovascular complications following CAR-T therapy.
Approach:
Study Design: Retrospective cohort study using the TriNetX Global Research Network to identify adults treated with CAR-T therapy between 2015 and 2025.
Patient Matching: Male and female patients were propensity score–matched 1:1 on baseline characteristics.
Outcomes Assessment: Primary outcome was MACE (myocardial infarction, stroke, all-cause mortality) assessed at 1- and 2-year follow-up; secondary outcomes included all-cause mortality and other cardiovascular complications.
Key Findings:
Males had a higher incidence of MACE at 1 year compared to females (558 vs. 437 events; RR: 1.22, 95% CI: 1.09–1.36).
This association persisted at 2 years (697 vs. 593 events; RR: 1.15, 95% CI: 1.05–1.26).
Males also had a higher risk of all-cause mortality and cardiovascular complications such as atrial fibrillation, ventricular arrhythmias, high-grade atrioventricular block, and pericarditis.
Interpretation:
Male sex was associated with a higher risk of MACE and greater burden of arrhythmic and conduction abnormalities following CAR-T therapy.
Limitations:
The study is based on retrospective data, which may introduce biases.
Findings may not be generalizable to all CAR-T therapy populations.
Conclusion:
Incorporating biological sex into cardiovascular risk assessment and monitoring strategies in patients undergoing CAR-T therapy is suggested.
