Accelerated Systemic Atherosclerosis Following Immune-Related Adverse Events in a Patient with Primary Thoracic Melanoma: A Case of Sequential Coronary and Peripheral Revascularization
Abstract
Immune checkpoint inhibitors (ICIs) improve survival in advanced melanoma, but they may accelerate atherosclerosis, particularly in patients with immune-related adverse events (irAEs). A 64-year-old man with stage IV BRAF-wild-type primary thoracic melanoma achieved complete remission after nivolumab plus ipilimumab, but he later developed grade 3 immune-related hepatitis, requiring treatment discontinuation. Three and a half years later, symptomatic peripheral artery disease required revascularization, followed by severe coronary artery disease requiring percutaneous coronary intervention one year later. This case suggests that severe irAEs may be associated with accelerated systemic atherosclerosis, highlighting the importance of long-term cardiovascular surveillance following ICI therapy.
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BibTeX
@article{nishikawa2026accelerated,
title = {{Accelerated Systemic Atherosclerosis Following Immune-Related Adverse Events in a Patient with Primary Thoracic Melanoma: A Case of Sequential Coronary and Peripheral Revascularization}},
author = {Tomoaki Nishikawa and Akinori Higaki and Saki Mori and Toru Miyoshi and Shoichiro Yamamoto and Osamu Yamaguchi},
journal = {Internal Medicine},
year = {2026},
month = oct,
doi = {10.2169/internalmedicine.8340-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8340-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Accelerated Systemic Atherosclerosis Following Immune-Related Adverse Events in a Patient with Primary Thoracic Melanoma: A Case of Sequential Coronary and Peripheral Revascularization
AU - Tomoaki Nishikawa
AU - Akinori Higaki
AU - Saki Mori
AU - Toru Miyoshi
AU - Shoichiro Yamamoto
AU - Osamu Yamaguchi
PY - 2026
DA - 2026/10/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.8340-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8340-26/_article
AB - Immune checkpoint inhibitors (ICIs) improve survival in advanced melanoma, but they may accelerate atherosclerosis, particularly in patients with immune-related adverse events (irAEs). A 64-year-old man with stage IV BRAF-wild-type primary thoracic melanoma achieved complete remission after nivolumab plus ipilimumab, but he later developed grade 3 immune-related hepatitis, requiring treatment discontinuation. Three and a half years later, symptomatic peripheral artery disease required revascularization, followed by severe coronary artery disease requiring percutaneous coronary intervention one year later. This case suggests that severe irAEs may be associated with accelerated systemic atherosclerosis, highlighting the importance of long-term cardiovascular surveillance following ICI therapy.
SN - 1349-7235
SN - 0918-2918
ER -