Cronin Michael, Crowley Aileen, Davey Matthew G, Ryan Peter, Abdelshafy Mahmoud, Elkoumy Ahmed, Elzomor Hesham, Arsang-Jang Shahram, Ganly Sandra, Nash Patrick, Crowley James, Sharif Faisal, Simpkin Andrew, Lowery Aoife, Wijns William, Kerin Michael, Soliman Osama
Discipline of Cardiology, Galway University Hospital, Health Service Executive, H91 TK33 Galway, Ireland.
CORRIB Core Lab., University of Galway, H91 TK33 Galway, Ireland.
J Clin Med. 2023 Feb 6;12(4):1278. doi: 10.3390/jcm12041278.
This paper looks to validate the risk score from the Heart Failure Association of the European Society of Cardiology and the International Cardio-Oncology Society (HFA-ICOS) for predicting potential cardiotoxicity from anticancer therapy for patients positive for human epidermal growth factor receptor 2.
A total of 507 patients with at least five years since index diagnosis of breast cancer were retrospectively divided according to the HFA-ICOS risk proforma. According to level of risk, these groups were assessed for rates of cardiotoxicity via mixed-effect Bayesian logistic regression model.
A follow-up of five years observed cardiotoxicity of 3.3% ( = 3) in the low-risk, 3.3% ( = 10) in the medium-risk, 4.4% ( = 6) in the high-risk, and 38% ( = 6) in the very-high-risk groups respectively. For cardiac events related to treatment, the risk was significantly higher for the very-high-risk category of HFA-ICOS compared to other categories (Beta = 3.1, 95% CrI: 1.5, 4.8). For overall cardiotoxicity related to treatment, the area under the curve was 0.643 (CI 95%: 0.51, 0.76), with 26.1% (95% CI: 8%, 44%) sensitivity and 97.9% (95% CI: 96%, 99%) specificity.
The HFA-ICOS risk score has moderate power in predicting cancer therapy-related cardiotoxicity in HER2-positive breast cancer patients.
本文旨在验证欧洲心脏病学会心力衰竭协会和国际心脏肿瘤学会（HFA-ICOS）的风险评分，以预测人表皮生长因子受体2阳性患者接受抗癌治疗时潜在的心脏毒性。
根据HFA-ICOS风险评估表，对507例自首次诊断乳腺癌至少已有五年的患者进行回顾性分组。根据风险水平，通过混合效应贝叶斯逻辑回归模型评估这些组的心脏毒性发生率。
五年随访观察到，低风险组心脏毒性发生率为3.3%（n = 3），中风险组为3.3%（n = 10），高风险组为4.4%（n = 6），极高风险组为38%（n = 6）。对于与治疗相关的心脏事件，HFA-ICOS极高风险类别与其他类别相比风险显著更高（β = 3.1，95% CrI：1.5，4.8）。对于与治疗相关的总体心脏毒性，曲线下面积为0.643（95% CI：0.51，0.76），敏感性为26.1%（95% CI：8%，44%），特异性为97.9%（95% CI：96%，99%）。
HFA-ICOS风险评分在预测HER2阳性乳腺癌患者癌症治疗相关心脏毒性方面具有中等效力。
