Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance
Abstract Background The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Design Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardi...
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| creator | Caro Codon, J Lopez-Fernandez, T Alvarez-Ortega, C Zamora Aunon, P Rodriguez Rodriguez, I Gomez Prieto, P Buno Soto, A Canales Albendea, M Feliu Batlle, J Rodriguez Fraga, O Martinez Monzonis, A Gonzalez-Costello, J Serrano Antolin, J.M Gonzalez-Juanatey, J.R Lopez-Sendon, J.L |
| description | Abstract
Background
The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown.
Design
Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods
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.
Results
At baseline, 893 patients (67.4%) presented at least 1 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 and all-cause mortality [HR 1.79 (95% 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 cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients.
Baseline characteristics abbreviated
Basal
All patients
SCORE 0–4
SCORE 5–9
SCORE ≥10
p value
(N=1324)
(N=1040)
(N=213)
(N=34)
Age, years
55.3±14.3
50.4±11.7
73.8±6.0
75.9±5.5 |
| doi_str_mv | 10.1093/ehjci/ehaa946.3251 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_ehjci_ehaa946_3251</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ehjci/ehaa946.3251</oup_id><sourcerecordid>10.1093/ehjci/ehaa946.3251</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1251-c57a1571de14fc41b5b65320004a46bed40404e30eb5d9ecc44135f8e1e716c43</originalsourceid><addsrcrecordid>eNqNUNFKAzEQDKJgrf6AT_kAr2bvkrTnmxStQsEXBd-Ovc1eTb3eleRa8O9NbT9AFnaXnZllGCFuQU1AlcU9f63Jp45YajspcgNnYgQmz7PSanMuRgpKk1k7-7wUVzGulVIzC3YkaI7B-X6PkXYtBhl8_JYN0tCHKN0u-G4lCTviIIfAOGy4Gx7kNvAeW07nO-k78u6wSuxcQvpV18fBkwzcJlYCrsVFg23km9Mci4_np_f5S7Z8W7zOH5cZQTKckZkimCk4Bt2QhtrU1hR5sqpR25qdVqm4UFwbVzKR1lCYZsbAU7Cki7HIj38p9DEGbqpt8BsMPxWo6hBT9RdTdYqpOsSURNlR1O-2_-H_Atg2bo0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Caro Codon, J ; Lopez-Fernandez, T ; Alvarez-Ortega, C ; Zamora Aunon, P ; Rodriguez Rodriguez, I ; Gomez Prieto, P ; Buno Soto, A ; Canales Albendea, M ; Feliu Batlle, J ; Rodriguez Fraga, O ; Martinez Monzonis, A ; Gonzalez-Costello, J ; Serrano Antolin, J.M ; Gonzalez-Juanatey, J.R ; Lopez-Sendon, J.L</creator><creatorcontrib>Caro Codon, J ; Lopez-Fernandez, T ; Alvarez-Ortega, C ; Zamora Aunon, P ; Rodriguez Rodriguez, I ; Gomez Prieto, P ; Buno Soto, A ; Canales Albendea, M ; Feliu Batlle, J ; Rodriguez Fraga, O ; Martinez Monzonis, A ; Gonzalez-Costello, J ; Serrano Antolin, J.M ; Gonzalez-Juanatey, J.R ; Lopez-Sendon, J.L</creatorcontrib><description>Abstract
Background
The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown.
Design
Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods
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.
Results
At baseline, 893 patients (67.4%) presented at least 1 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 and all-cause mortality [HR 1.79 (95% 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 cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients.
Baseline characteristics abbreviated
Basal
All patients
SCORE 0–4
SCORE 5–9
SCORE ≥10
p value
(N=1324)
(N=1040)
(N=213)
(N=34)
Age, years
55.3±14.3
50.4±11.7
73.8±6.0
75.9±5.5
<0.001
Men
259 (19.5%)
150 (14.4%)
53 (24.9%)
33 (97.1%)
<0.001
Prior cancer history
132 (10.0%)
95 (9.1%)
27 (12.7%)
6 (17.7%)
0.119
Breast cancer
799 (60.4%)
683 (65.7%)
109 (51.2%)
1 (2.9%)
<0.001
Non-Hodgkin lymphoma
205 (15.5%)
125 (12.0%)
55 (25.8%)
13 (38.2%)
<0.001
Hodgkin lymphoma
66 (5.0%)
60 (5.8%)
4 (1.9%)
2 (5.9%)
0.035
Acute Myeloblastic Leukemia
49 (3.7%)
34 (3.3%)
12 (5.6%)
1 (2.9%)
0.245
LVEF %
63.6±6.7
63.8±6.2
63.2±7.6
60.0±10.9
0.006
Antracyclines
1066 (80.5%)
879 (84.5%)
151 (70.9%)
17 (50%)
<0.001
Anti HER2
242 (18.3%)
205 (19.7%)
34 (16.0%)
0 (0.0%)
0.002
Left breast Radiotherapy
189 (14.3%)
162 (15.6%)
26 (12.2%)
1 (2.9%)
0.059
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/ehjci/ehaa946.3251</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2020-11, Vol.41 (Supplement_2)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Caro Codon, J</creatorcontrib><creatorcontrib>Lopez-Fernandez, T</creatorcontrib><creatorcontrib>Alvarez-Ortega, C</creatorcontrib><creatorcontrib>Zamora Aunon, P</creatorcontrib><creatorcontrib>Rodriguez Rodriguez, I</creatorcontrib><creatorcontrib>Gomez Prieto, P</creatorcontrib><creatorcontrib>Buno Soto, A</creatorcontrib><creatorcontrib>Canales Albendea, M</creatorcontrib><creatorcontrib>Feliu Batlle, J</creatorcontrib><creatorcontrib>Rodriguez Fraga, O</creatorcontrib><creatorcontrib>Martinez Monzonis, A</creatorcontrib><creatorcontrib>Gonzalez-Costello, J</creatorcontrib><creatorcontrib>Serrano Antolin, J.M</creatorcontrib><creatorcontrib>Gonzalez-Juanatey, J.R</creatorcontrib><creatorcontrib>Lopez-Sendon, J.L</creatorcontrib><title>Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance</title><title>European heart journal</title><description>Abstract
Background
The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown.
Design
Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods
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.
Results
At baseline, 893 patients (67.4%) presented at least 1 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 and all-cause mortality [HR 1.79 (95% 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 cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients.
Baseline characteristics abbreviated
Basal
All patients
SCORE 0–4
SCORE 5–9
SCORE ≥10
p value
(N=1324)
(N=1040)
(N=213)
(N=34)
Age, years
55.3±14.3
50.4±11.7
73.8±6.0
75.9±5.5
<0.001
Men
259 (19.5%)
150 (14.4%)
53 (24.9%)
33 (97.1%)
<0.001
Prior cancer history
132 (10.0%)
95 (9.1%)
27 (12.7%)
6 (17.7%)
0.119
Breast cancer
799 (60.4%)
683 (65.7%)
109 (51.2%)
1 (2.9%)
<0.001
Non-Hodgkin lymphoma
205 (15.5%)
125 (12.0%)
55 (25.8%)
13 (38.2%)
<0.001
Hodgkin lymphoma
66 (5.0%)
60 (5.8%)
4 (1.9%)
2 (5.9%)
0.035
Acute Myeloblastic Leukemia
49 (3.7%)
34 (3.3%)
12 (5.6%)
1 (2.9%)
0.245
LVEF %
63.6±6.7
63.8±6.2
63.2±7.6
60.0±10.9
0.006
Antracyclines
1066 (80.5%)
879 (84.5%)
151 (70.9%)
17 (50%)
<0.001
Anti HER2
242 (18.3%)
205 (19.7%)
34 (16.0%)
0 (0.0%)
0.002
Left breast Radiotherapy
189 (14.3%)
162 (15.6%)
26 (12.2%)
1 (2.9%)
0.059
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNUNFKAzEQDKJgrf6AT_kAr2bvkrTnmxStQsEXBd-Ovc1eTb3eleRa8O9NbT9AFnaXnZllGCFuQU1AlcU9f63Jp45YajspcgNnYgQmz7PSanMuRgpKk1k7-7wUVzGulVIzC3YkaI7B-X6PkXYtBhl8_JYN0tCHKN0u-G4lCTviIIfAOGy4Gx7kNvAeW07nO-k78u6wSuxcQvpV18fBkwzcJlYCrsVFg23km9Mci4_np_f5S7Z8W7zOH5cZQTKckZkimCk4Bt2QhtrU1hR5sqpR25qdVqm4UFwbVzKR1lCYZsbAU7Cki7HIj38p9DEGbqpt8BsMPxWo6hBT9RdTdYqpOsSURNlR1O-2_-H_Atg2bo0</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Caro Codon, J</creator><creator>Lopez-Fernandez, T</creator><creator>Alvarez-Ortega, C</creator><creator>Zamora Aunon, P</creator><creator>Rodriguez Rodriguez, I</creator><creator>Gomez Prieto, P</creator><creator>Buno Soto, A</creator><creator>Canales Albendea, M</creator><creator>Feliu Batlle, J</creator><creator>Rodriguez Fraga, O</creator><creator>Martinez Monzonis, A</creator><creator>Gonzalez-Costello, J</creator><creator>Serrano Antolin, J.M</creator><creator>Gonzalez-Juanatey, J.R</creator><creator>Lopez-Sendon, J.L</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20201101</creationdate><title>Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance</title><author>Caro Codon, J ; Lopez-Fernandez, T ; Alvarez-Ortega, C ; Zamora Aunon, P ; Rodriguez Rodriguez, I ; Gomez Prieto, P ; Buno Soto, A ; Canales Albendea, M ; Feliu Batlle, J ; Rodriguez Fraga, O ; Martinez Monzonis, A ; Gonzalez-Costello, J ; Serrano Antolin, J.M ; Gonzalez-Juanatey, J.R ; Lopez-Sendon, J.L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1251-c57a1571de14fc41b5b65320004a46bed40404e30eb5d9ecc44135f8e1e716c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Caro Codon, J</creatorcontrib><creatorcontrib>Lopez-Fernandez, T</creatorcontrib><creatorcontrib>Alvarez-Ortega, C</creatorcontrib><creatorcontrib>Zamora Aunon, P</creatorcontrib><creatorcontrib>Rodriguez Rodriguez, I</creatorcontrib><creatorcontrib>Gomez Prieto, P</creatorcontrib><creatorcontrib>Buno Soto, A</creatorcontrib><creatorcontrib>Canales Albendea, M</creatorcontrib><creatorcontrib>Feliu Batlle, J</creatorcontrib><creatorcontrib>Rodriguez Fraga, O</creatorcontrib><creatorcontrib>Martinez Monzonis, A</creatorcontrib><creatorcontrib>Gonzalez-Costello, J</creatorcontrib><creatorcontrib>Serrano Antolin, J.M</creatorcontrib><creatorcontrib>Gonzalez-Juanatey, J.R</creatorcontrib><creatorcontrib>Lopez-Sendon, J.L</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Caro Codon, J</au><au>Lopez-Fernandez, T</au><au>Alvarez-Ortega, C</au><au>Zamora Aunon, P</au><au>Rodriguez Rodriguez, I</au><au>Gomez Prieto, P</au><au>Buno Soto, A</au><au>Canales Albendea, M</au><au>Feliu Batlle, J</au><au>Rodriguez Fraga, O</au><au>Martinez Monzonis, A</au><au>Gonzalez-Costello, J</au><au>Serrano Antolin, J.M</au><au>Gonzalez-Juanatey, J.R</au><au>Lopez-Sendon, J.L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance</atitle><jtitle>European heart journal</jtitle><date>2020-11-01</date><risdate>2020</risdate><volume>41</volume><issue>Supplement_2</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown.
Design
Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods
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.
Results
At baseline, 893 patients (67.4%) presented at least 1 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 and all-cause mortality [HR 1.79 (95% 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 cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients.
Baseline characteristics abbreviated
Basal
All patients
SCORE 0–4
SCORE 5–9
SCORE ≥10
p value
(N=1324)
(N=1040)
(N=213)
(N=34)
Age, years
55.3±14.3
50.4±11.7
73.8±6.0
75.9±5.5
<0.001
Men
259 (19.5%)
150 (14.4%)
53 (24.9%)
33 (97.1%)
<0.001
Prior cancer history
132 (10.0%)
95 (9.1%)
27 (12.7%)
6 (17.7%)
0.119
Breast cancer
799 (60.4%)
683 (65.7%)
109 (51.2%)
1 (2.9%)
<0.001
Non-Hodgkin lymphoma
205 (15.5%)
125 (12.0%)
55 (25.8%)
13 (38.2%)
<0.001
Hodgkin lymphoma
66 (5.0%)
60 (5.8%)
4 (1.9%)
2 (5.9%)
0.035
Acute Myeloblastic Leukemia
49 (3.7%)
34 (3.3%)
12 (5.6%)
1 (2.9%)
0.245
LVEF %
63.6±6.7
63.8±6.2
63.2±7.6
60.0±10.9
0.006
Antracyclines
1066 (80.5%)
879 (84.5%)
151 (70.9%)
17 (50%)
<0.001
Anti HER2
242 (18.3%)
205 (19.7%)
34 (16.0%)
0 (0.0%)
0.002
Left breast Radiotherapy
189 (14.3%)
162 (15.6%)
26 (12.2%)
1 (2.9%)
0.059
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)</abstract><pub>Oxford University Press</pub><doi>10.1093/ehjci/ehaa946.3251</doi><oa>free_for_read</oa></addata></record> |
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| issn | 0195-668X 1522-9645 |
| language | eng |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| title | Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance |
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