SPC365

Cancer therapy-related cardiovascular toxicity: what’s the accuracy of baseline cardiovascular risk stratification in the prediction of its occurrence?

Session: Sessão de Posters 12 - Cardio-oncologia e Medicina na Gravidez
Speaker: Beatriz Andrade

Congress: CPC 2024
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.6 Cardio-Oncology
Session Type: Cartazes
FP Number: ---
Authors: Beatriz Vargas Andrade; Bruno Castilho; Nuno Cotrim; Catarina Gonçalves Coelho; Rita Veiga; Mariana Saraiva; Sandra Bento; Vítor Martins

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Introduction:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Advances in cancer prevention and treatment have significantly improved survival, but cancer therapy-related cardiovascular toxicity (CTR-CVT) is a growing concern. Comprehensive baseline cardiovascular risk (BCVR) assessment is crucial to make appropriate cancer treatment choices and define prevention and surveillance strategies. Validation of the International Cardio-Oncology Society (HFA-ICOS) BCVR assessment tools is not yet robustly established.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Purpose:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> To evaluate the accuracy of BCVR assessment tools published by HFA-ICOS in predicting the occurrence of CTR-CVT in a Portuguese population.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Retrospective study of a population submitted to cancer therapy at risk for CV toxicity and followed in CO&nbsp;consultation. BCVR was defined according to HFA-ICOS assessment tool and CTR-CVT according to 2022 ESC CO guidelines. Primary endpoint was evidence of CTR-CVT during follow-up (FU). For patients (pts) treated both with anthracyclines (AC) and HER2-targeted therapies (anti-HER2), the risk was calculated by the proforma for anti-HER2.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Results:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> We included 75 pts, mean age 62.3&plusmn;10.6 years, 84% female, with mean FU of 34 months. The majority (80%)&nbsp;had breast cancer, followed by gastrointestinal (6.7%) and prostate (4%) malignancies. A significant proportion had advanced disease (33.3% with metastasis). 28% of pts had &ge;1 hospital admission and overall mortality rate during FU was 26.7%. Regarding chemotherapy regimens, 44% were exposed to AC, 36% to AC plus anti-HER2 and 8% only to anti-HER2. From the remaining pts, 8% received VEGF-inhibitors and 4% androgen deprivation therapies. 28% had low BCVR, 36% intermediate risk, 24% high risk and 12% very high risk. 30% of the pts were treated with cardioprotective drugs regardless of CTR-CVT, due to comorbidities.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">22.7% of pts reached the endpoint, mainly in the form of left ventricular systolic dysfunction. Of these, 58.8% were symptomatic. There was no statistically significant association&nbsp;between BCVR and the development of CTR-CVT, either symptomatic or not. Regarding cardioprotective drugs, we didn&rsquo;t find a&nbsp;statistically significant difference&nbsp;between the use of statins, beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at baseline and the development of CTR-CVT. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">In our population, mainly composed by breast cancer female pts, the BCVR didn&rsquo;t correlate with the development of CTR-CVT. Further studies are needed to clarify if the HFA/ICOS assessment tool should be revised in order to improve risk stratification. </span></span></span></span></p>