Anthracycline-induced cardiovascular toxicity: validation of the Heart Failure Association and International Cardio-Oncology Society risk score.

Autor:	Rivero-Santana B; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., Saldaña-García J; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., Caro-Codón J; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., Zamora P; Oncology Department, La Paz University Hospital, IdiPAZ Research Institute, CIBER ONC, Madrid, Spain., Moliner P; Cardiology Department, Bellvitge University Hospital, Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, CIBER CV, Barcelona, Spain., Martínez Monzonis A; Cardiology Department, Clinic University Hospital, IDIS Research Institute, CIBERCV, Santiago de Compostela, Spain., Zatarain E; Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBER-CV (ISCIII), IISGM, Complutense University, Madrid, Spain., Álvarez-Ortega C; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., Gómez-Prieto P; Hematology Department, La Paz University Hospital, IdiPAZ Research Institute, Madrid, Spain., Pernas S; Medical Oncology Department, Institut Catala d'Oncologia-H.U.Bellvitge-IDIBELL, L'Hospitalet, Barcelona, Spain., Rodriguez I; Radiation Oncology Department, La Paz University Hospital, IdiPAZ Research Institute, Madrid, Spain., Buño Soto A; Department of Laboratory Medicine, La Paz University Hospital, IdiPAZ Research Institute, Madrid, Spain., Cadenas R; Cardiology Department, Infanta Sofía University Hospital, European University of Madrid, Madrid, Spain., Palacios Ozores P; Oncology Department, Oncology Translational Research Group, Clinic University Hospital, IDIS Research Institute, Santiago de Compostela, Spain., Pérez Ramírez S; Oncology Department, Hospital Gregorio Marañon, Madrid, Spain., Merino Salvador M; Medical Oncology Department, Infanta Sofía University Hospital, Infanta Sofía University Hospital, Henares University Hospital Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain., Valbuena S; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., Fernández Gasso L; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., Juárez V; Cardiology Department, Hospital Universitario 12 de Octubre, CIBER CV, Madrid, Spain., Severo A; Cardiology Department, Hospital Universitario 12 de Octubre, CIBER CV, Madrid, Spain., Terol B; Cardiology Department, Hospital Universitario Quironsalud, C. Diego de Velázquez, 1, 28223 Pozuelo de Alarcón, Madrid, Spain., de Soto Álvarez T; Hematology Department, La Paz University Hospital, IdiPAZ Research Institute, Madrid, Spain., Rodríguez O; Department of Laboratory Medicine, La Paz University Hospital, IdiPAZ Research Institute, Madrid, Spain., Brion M; Cardiology Department, Clinic University Hospital, IDIS Research Institute, CIBERCV, Santiago de Compostela, Spain., González-Costello J; Cardiology Department, Bellvitge University Hospital, Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, CIBER CV, Barcelona, Spain., Canales Albendea M; Department of Hematology, Clínica Universidad de Navarra, Pamplona, Spain., González-Juanatey JR; Cardiology Department, Clinic University Hospital, IDIS Research Institute, CIBERCV, Santiago de Compostela, Spain., Moreno R; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain., López-Sendón J; Scientific Director, IdiPAZ Research Institute, Madrid, Spain., López-Fernández T; Cardiology Department, La Paz University Hospital, IdiPAZ Research Institute, C/Paseo de la Castellana n° 261, 28046 Madrid, Spain.; Cardiology Department, Hospital Universitario Quironsalud, C. Diego de Velázquez, 1, 28223 Pozuelo de Alarcón, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2024 Aug 06. Date of Electronic Publication: 2024 Aug 06.
DOI:	10.1093/eurheartj/ehae496
Abstrakt:	Background and Aims: Baseline cardiovascular toxicity risk stratification is critical in cardio-oncology. The Heart Failure Association (HFA) and International Cardio-Oncology Society (ICOS) score aims to assess this risk but lacks real-life validation. This study validates the HFA-ICOS score for anthracycline-induced cardiovascular toxicity. Methods: Anthracycline-treated patients in the CARDIOTOX registry (NCT02039622) were stratified by the HFA-ICOS score. The primary endpoint was symptomatic or moderate to severe asymptomatic cancer therapy-related cardiac dysfunction (CTRCD), with all-cause mortality and cardiovascular mortality as secondary endpoints. Results: The analysis included 1066 patients (mean age 54 ± 14 years; 81.9% women; 24.5% ≥65 years). According to the HFA-ICOS criteria, 571 patients (53.6%) were classified as low risk, 333 (31.2%) as moderate risk, 152 (14.3%) as high risk, and 10 (0.9%) as very high risk. Median follow-up was 54.8 months (interquartile range 24.6-81.8). A total of 197 patients (18.4%) died, and 718 (67.3%) developed CTRCD (symptomatic: n = 45; moderate to severe asymptomatic: n = 24; and mild asymptomatic: n = 649). Incidence rates of symptomatic or moderate to severe symptomatic CTRCD and all-cause mortality significantly increased with HFA-ICOS score [hazard ratio 28.74, 95% confidence interval (CI) 9.33-88.5; P < .001, and hazard ratio 7.43, 95% CI 3.21-17.2; P < .001) for very high-risk patients. The predictive model demonstrated good calibration (Brier score 0.04, 95% CI 0.03-0.05) and discrimination (area under the curve 0.78, 95% CI 0.70-0.82; Uno's C-statistic 0.78, 95% CI 0.71-0.84) for predicting symptomatic or severe/moderate asymptomatic CTRCD at 12 months. Conclusions: The HFA-ICOS score effectively categorizes patients by cardiovascular toxicity risk and demonstrates strong predictive ability for high-risk anthracycline-related cardiovascular toxicity and all-cause mortality. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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