Cardio-oncology & otherCohort study
Anthracycline-induced cardiovascular toxicity: validation of the Heart Failure Association and International Cardio-Oncology Society risk score
- Registry-based cohort study (risk score validation)
Authors' conclusion
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.
Study context
- Population
- Anthracycline-treated patients in the CARDIOTOX registry
- Participants
- 1,066 patients
- Exposure
- HFA-ICOS risk categories
- Low riskn = 571reference
- Moderate riskn = 333
- High riskn = 152
- Very high riskn = 10
- Outcome
- Symptomatic or moderate to severe asymptomatic CTRCD
Main finding
As reported in the abstract
median follow-up 54.8 months (IQR 24.6-81.8)
Hazard ratio
28.74
95% CI 9.33–88.5
P < 0.001
Very high risk vs Low risk
HR 28.74 (95% CI 9.33–88.5); P < 0.001
- Cancer therapy-related cardiac dysfunction (CTRCD) overall (incl. mild asymptomatic)
- 718 (67.3%)
- Symptomatic CTRCD
- 45
- Moderate to severe asymptomatic CTRCD
- 24
- Mild asymptomatic CTRCD
- 649
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality | 7.43 (3.21–17.2) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
- All-cause mortality — Deaths
- 197 (18.4%)
Model performance for symptomatic or moderate/severe asymptomatic CTRCD · 12 months
- Brier score (calibration)
- 0.04, 95% CI 0.03-0.05
- AUC
- 0.78, 95% CI 0.70-0.82
- Uno's C-statistic
- 0.78, 95% CI 0.71-0.84
Original publication
Anthracycline-induced cardiovascular toxicity: validation of the Heart Failure Association and International Cardio-Oncology Society risk score. Eur Heart J. Published 6 August 2024. doi:10.1093/eurheartj/ehae496
Summarised from the published abstract; every number is checked against it