Background

the European Society of Cardiology Heart Failure Association (HFA) together with the International Cardio-Oncology Society (ICOS) proposed charts for baseline CV risk assessment of cancer patients scheduled to receive anthracyclines and anti-human epidermal growth factor receptor-2 (HER2) agents.

Methods

We investigated HFA/ICOS risk stratification, prescriptions of cardioactive drugs, and occurrence of CV events in a multicentric breast cancer (BC) cohort from 3 Italian Outpatient Cardio-Oncology Clinics.

Results

373 BC patients who underwent a baseline Cardio-Oncologic evaluation were included, of whom 202 scheduled to receive anthracyclines and 171 anti-HER2. Mean age was 60 ± 12 years and 49% of BC patients had ≥2 CV risk factors. In the anthracyclines group, 51% were at low-risk, 43% at medium-risk and 6% at high-risk; while in the anti-HER2 group, 27% patients were at low-risk, 58% at medium-risk and 15% at high-risk. In both groups, a medium-to-high risk was associated with use of cardioactive therapies (p < 0.0001). There were no LVD events in anthracycline recipients, and 16 LVD among anti-HER2 patients. A medium-to-high risk was not associated with LVD occurrence (p = 0.17).

Conclusions

Patients with medium-to-high HFA/ICOS risk were more likely to receive cardioactive therapies, possibly explaining the lack of association of risk categories with LVD occurrence.

中文翻译：

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乳腺癌女性的基线心脏肿瘤风险评估和心血管事件的发生：现实世界实践中的 HFA/ICOS 风险工具

背景

欧洲心脏病学会心力衰竭协会 (HFA) 与国际心脏肿瘤学会 (ICOS) 提出了计划接受蒽环类药物和抗人表皮生长因子受体-2 (HER2) 药物治疗的癌症患者基线心血管风险评估图表.

方法

我们调查了来自意大利 3 个门诊心脏肿瘤诊所的多中心乳腺癌 (BC) 队列中的 HFA/ICOS 风险分层、心脏活性药物的处方和心血管事件的发生。

结果

纳入了 373 名接受基线心脏肿瘤学评估的 BC 患者，其中 202 名计划接受蒽环类药物和 171 名抗 HER2。平均年龄为 60 ± 12 岁，49% 的 BC 患者有 ≥2 个 CV 危险因素。在蒽环类药物组中，51% 为低风险，43% 为中风险，6% 为高风险；而在抗HER2组中，27%的患者处于低风险，58%处于中等风险，15%处于高风险。在两组中，中高风险与心脏活性疗法的使用相关（p < 0.0001）。蒽环类药物接受者没有 LVD 事件，抗 HER2 患者中有 16 例 LVD。中高风险与 LVD 的发生无关（p = 0.17）。

结论

具有中高 HFA/ICOS 风险的患者更有可能接受心脏活性治疗，这可能解释了风险类别与 LVD 发生缺乏关联的原因。