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

Abstract

Aims 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. Methods and results 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)]. Conclusions 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.

Mechanisms of tumor-associated cardiac muscle damage under different variants of melanoma growth

“…An increasing number of oncological patients face their risks of the cardiovascular dysfunction that results in the appearance of a new area, namely, cardiooncology, or oncocardiology [1][2][3]. Higher survival rates in oncological patients lead to a greater risk of some other life-threatening conditions, in particular cardiovascular diseases (CVD) that is considered to be a second leading cause of mortality and the CVD incidence in cancer survivors [4].…”

Cardiovascular, diabetes, and cancer strips: New evidences from clinical cases in Nanchang, China

“…However, whether this viral infection links highly to CDC strips or not, it's indeed a novel project. In addition, during cancer treatment and follow-up 44 , there are signi cant prevalence and incidence of CV risk factors. Thus, long-term follow-up is needed to observe the outcome and prognosis.…”

Racial and rural–urban disparities in cardiovascular risk factors among patients with head and neck cancer in a clinical cohort

“…Cancer patients with pre‐existing CVD risk factors at cancer diagnosis are more likely to develop cardiac side effects from cancer therapies and are more likely to die from CVD outcomes than patients without pre‐existing CVD risk factors 6,8,9 . However, literature in cardio‐oncology is mostly focused on CVD outcomes and cancer treatment‐related cardiotoxicities; reports on the distribution of traditional CVD risk factors like hypertension, dyslipidemia, diabetes mellitus, tobacco use, and obesity in patients with cancer is limited 10,11 . Most of these studies assessed CVD risk factors post cancer treatment 10,12 .…”

“…6,8,9 However, literature in cardio-oncology is mostly focused on CVD outcomes and cancer treatment-related cardiotoxicities; reports on the distribution of traditional CVD risk factors like hypertension, dyslipidemia, diabetes mellitus, tobacco use, and obesity in patients with cancer is limited. 10,11 Most of these studies assessed CVD risk factors post cancer treatment. 10,12 Additionally, data on modifiable CVD risk factors in patients with head and neck cancer (HNC) is under-reported.…”