The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity
Abstract Aims Tyrosine kinase inhibitors (TKIs) used to treat chronic myeloid leukaemia (CML) can cause cardiovascular adverse events. So far, the Systematic Coronary Risk Evaluation (SCORE) charts of the European Society of Cardiology (ESC) have been used to identify cancer patients at increased ca...
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| Format: | Article |
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Wiley
2022-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13897 |
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| author | Daniela Di Lisi Cristina Madaudo Giulia Alagna Marco Santoro Ludovico Rossetto Sergio Siragusa Giuseppina Novo |
| author_facet | Daniela Di Lisi Cristina Madaudo Giulia Alagna Marco Santoro Ludovico Rossetto Sergio Siragusa Giuseppina Novo |
| author_sort | Daniela Di Lisi |
| collection | DOAJ |
| description | Abstract Aims Tyrosine kinase inhibitors (TKIs) used to treat chronic myeloid leukaemia (CML) can cause cardiovascular adverse events. So far, the Systematic Coronary Risk Evaluation (SCORE) charts of the European Society of Cardiology (ESC) have been used to identify cancer patients at increased cardiovascular risk. The primary aim of our study was to evaluate the usefulness of the new cardiovascular risk assessment model proposed by the Cardio‐Oncology Study Group of the Heart Failure Association (HFA) of the ESC in collaboration with the International Cardio‐Oncology Society (ICOS) to stratify the cardiovascular risk in CML patients, compared with SCORE risk charts. The secondary aim was to establish the incidence of adverse arterial events (AEs) in patients with CML treated with TKIs and the influence of preventive treatment with aspirin. Methods and results A retrospective single‐centre observational study was carried out on 58 patients (32 men and 26 women; mean age ± SD: 59 ± 15 years) with CML treated with TKIs for a median period of 43 ± 31 months. Cardiological evaluation was performed and cardiovascular risk was estimated with SCORE risk charts and with the new risk assessment tool proposed by HFA/ICOS. AEs were recorded. According to SCORE charts and the new HFA/ICOS risk stratification tool, respectively, 46% (Group A1) and 60% (Group A2) of patients were at high–very high risk, and 54% (Group B1) and 40% (Group B2) at low–moderate risk. AEs were significantly more frequent in Group A1 than Group B1 (P value < 0.01) when considered overall; they were significantly more frequent in Group A2 than Group B2 either overall or considered individually. HFA/ICOS risk stratification tool was significantly more sensitive than SCORE (P < 0.01) in identifying patients at higher risk of cardiovascular toxicity. In addition, we did not find AEs in patients pretreated with aspirin. Conclusions The new HFA/ICOS risk stratification model allows a more tailored cardiovascular risk stratification in patients with CML and it is more sensitive than SCORE charts. |
| format | Article |
| id | doaj-art-3b73a1956db84513b199c8ed4ad86e6c |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-3b73a1956db84513b199c8ed4ad86e6c2025-02-05T05:22:10ZengWileyESC Heart Failure2055-58222022-06-01931914191910.1002/ehf2.13897The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicityDaniela Di Lisi0Cristina Madaudo1Giulia Alagna2Marco Santoro3Ludovico Rossetto4Sergio Siragusa5Giuseppina Novo6Cardiology Unit University Hospital Paolo Giaccone Palermo ItalyCardiology Unit University Hospital Paolo Giaccone Palermo ItalyCardiology Unit University Hospital Paolo Giaccone Palermo ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) University of Palermo Palermo ItalyCardiology Unit University Hospital Paolo Giaccone Palermo ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) University of Palermo Palermo ItalyCardiology Unit University Hospital Paolo Giaccone Palermo ItalyAbstract Aims Tyrosine kinase inhibitors (TKIs) used to treat chronic myeloid leukaemia (CML) can cause cardiovascular adverse events. So far, the Systematic Coronary Risk Evaluation (SCORE) charts of the European Society of Cardiology (ESC) have been used to identify cancer patients at increased cardiovascular risk. The primary aim of our study was to evaluate the usefulness of the new cardiovascular risk assessment model proposed by the Cardio‐Oncology Study Group of the Heart Failure Association (HFA) of the ESC in collaboration with the International Cardio‐Oncology Society (ICOS) to stratify the cardiovascular risk in CML patients, compared with SCORE risk charts. The secondary aim was to establish the incidence of adverse arterial events (AEs) in patients with CML treated with TKIs and the influence of preventive treatment with aspirin. Methods and results A retrospective single‐centre observational study was carried out on 58 patients (32 men and 26 women; mean age ± SD: 59 ± 15 years) with CML treated with TKIs for a median period of 43 ± 31 months. Cardiological evaluation was performed and cardiovascular risk was estimated with SCORE risk charts and with the new risk assessment tool proposed by HFA/ICOS. AEs were recorded. According to SCORE charts and the new HFA/ICOS risk stratification tool, respectively, 46% (Group A1) and 60% (Group A2) of patients were at high–very high risk, and 54% (Group B1) and 40% (Group B2) at low–moderate risk. AEs were significantly more frequent in Group A1 than Group B1 (P value < 0.01) when considered overall; they were significantly more frequent in Group A2 than Group B2 either overall or considered individually. HFA/ICOS risk stratification tool was significantly more sensitive than SCORE (P < 0.01) in identifying patients at higher risk of cardiovascular toxicity. In addition, we did not find AEs in patients pretreated with aspirin. Conclusions The new HFA/ICOS risk stratification model allows a more tailored cardiovascular risk stratification in patients with CML and it is more sensitive than SCORE charts.https://doi.org/10.1002/ehf2.13897Cardio‐oncologyCardiovascular preventionChronic myeloid leukaemiaNilotinibPonatinibCardiovascular toxicity |
| spellingShingle | Daniela Di Lisi Cristina Madaudo Giulia Alagna Marco Santoro Ludovico Rossetto Sergio Siragusa Giuseppina Novo The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity ESC Heart Failure Cardio‐oncology Cardiovascular prevention Chronic myeloid leukaemia Nilotinib Ponatinib Cardiovascular toxicity |
| title | The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity |
| title_full | The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity |
| title_fullStr | The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity |
| title_full_unstemmed | The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity |
| title_short | The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity |
| title_sort | new hfa icos risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity |
| topic | Cardio‐oncology Cardiovascular prevention Chronic myeloid leukaemia Nilotinib Ponatinib Cardiovascular toxicity |
| url | https://doi.org/10.1002/ehf2.13897 |
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