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Cardiovascular risk factors during cancer treatment. Prevalence and prognostic relevance: insights from the CARDIOTOX registry.

Authors
  • Caro-Codón, Juan1
  • López-Fernández, Teresa1
  • Álvarez-Ortega, Carlos1
  • Zamora Auñón, Pilar2
  • Rodríguez, Isabel Rodríguez3
  • Gómez Prieto, Pilar4
  • Buño Soto, Antonio5
  • Canales Albendea, Miguel4
  • Albaladejo, Ainara1
  • Mediavilla, Guiomar1
  • Feliu Batlle, Jaime2
  • Rodríguez Fraga, Olaia5
  • Martínez Monzonis, Amparo6
  • González-Costello, José7
  • Serrano Antolín, José María8
  • Cadenas Chamorro, Rosalía9
  • González-Juanatey, José R6
  • López-Sendón, José1
  • 1 Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain. , (Spain)
  • 2 Oncology Department, University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain. , (Spain)
  • 3 Oncoradiotherapy Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain. , (Spain)
  • 4 Hematology Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain. , (Spain)
  • 5 Clinical Analytics Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain. , (Spain)
  • 6 Department of Cardiology, University Hospital of Santiago de Compostela, CiberCV, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain. , (Spain)
  • 7 Department of Cardiology, University Hospital of Bellvitge, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. , (Spain)
  • 8 Department of Cardiology, University Hospital of Fuenlabrada, Camino del Molino, 2, 28942 Fuenlabrada, Madrid, Spain. , (Spain)
  • 9 Department of Cardiology, University Hospital Infanta Sofia, Paseo de Europa, 34, 28703 San Sebastián de los Reyes, Madrid, Spain. , (Spain)
Type
Published Article
Journal
European Journal of Preventive Cardiology
Publisher
SAGE Publications
Publication Date
May 06, 2022
Volume
29
Issue
6
Pages
859–868
Identifiers
DOI: 10.1093/eurjpc/zwaa034
PMID: 33624069
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The actual usefulness of cardiovascular (CV) risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Prospective multicentre study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk. A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples, and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years, and 2 years after initiation of cancer therapy. At baseline, 893 patients (67.4%) presented at least one risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity (CTox) and all-cause mortality [hazard ratio (HR) 1.79 (95% confidence interval, CI 1.16-2.76) for SCORE 5-9 and HR 4.90 (95% CI 2.44-9.82) for SCORE ≥10 when compared with patients with lower SCORE (0-4)]. This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline CV risk assessment using SCORE predicted severe CTox and all-cause mortality. Therefore, its use should be considered in the evaluation of cancer patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected]

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