免疫检查点抑制剂（ICIs）已成为各种恶性肿瘤的标准治疗方法。然而，研究表明阻断免疫检查点通路可能加重动脉粥样硬化病变。我们旨在研究ICI治疗是否增加了动脉血栓栓塞事件（ATEs）的风险。我们在2018年至2021年间对我们机构的经组织学证实的癌症患者进行了回顾性队列研究，采用倾向性分数匹配方法。主要终点为ATEs发生，包括急性冠脉综合征、中风/短暂性脑缺血发作和外周动脉血栓栓塞。亚组分析评估ICI治疗对ATEs的影响是否随时间变化，通过限制最大随访时间。逻辑回归分析确定了ICI治疗患者ATE风险因素。总体而言，ICI组（n = 2877）的ATEs风险是非ICI组的2.01倍（RR，2.01 [95％CI（1.61-2.51）]；p <0.001）。亚组分析显示，在1年内，ICI治疗患者的ATE风险没有显着增加（最多9个月随访，p = 0.075）。然而，ICI组的ATE风险在1年后增加了41％（p = 0.010），在4年后增加了97％（p≤0.001）。年龄、糖尿病、高血压、外周动脉粥样硬化、心房颤动、慢性缺血性心脏病、远处癌转移和ICI治疗周期是ICI治疗患者ATE风险升高的因素。ICI治疗患者可能存在较高的ATE风险，尤其是在治疗1年后。© 2023 The Authors. Cancer Medicine 由John Wiley & Sons Ltd.发表。

Immune checkpoint inhibitors (ICIs) have emerged as a standard treatment for various malignancies. However, research indicates blocking the immune checkpoint pathway may exacerbate atherosclerotic lesions.We aimed to investigate whether ICI therapy increases the risk of arterial thromboembolic events (ATEs).A retrospective cohort study was conducted on patients with histologically confirmed cancer at our institution between 2018 and 2021, using the propensity score matching method. The primary endpoint was ATEs occurrence, comprising acute coronary syndrome, stroke/transient ischemic attack, and peripheral arterial thromboembolism. Subgroup analyses assessed whether the ICI treatment effect on ATEs varied over time by limiting the maximum follow-up duration. Logistic regression analysis identified ATE risk factors in ICI-treated patients.Overall, the ICI group (n = 2877) demonstrated an ATEs risk 2.01 times higher than the non-ICI group (RR, 2.01 [95% CI (1.61-2.51)]; p < 0.001). Subgroup analysis revealed no significant increase in ATEs risk for ICI-treated patients within 1 year (Limited to a max 9-month follow-up, p = 0.075). However, ATEs risk in the ICI group rose by 41% at 1 year (p = 0.010) and 97% at 4 years (p ≤ 0.001). Age, diabetes, hypertension, peripheral atherosclerosis, atrial fibrillation, chronic ischemic heart disease, distant cancer metastasis, and ICI treatment cycles contributed to ATEs risk elevation in ICI-treated patients.ICI-treated patients may exhibit a higher risk of ATEs, especially after 1 year of treatment.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.