The new HFA/ICOS risk assessment tool to identify patients with chronic myeloid leukaemia at high risk of cardiotoxicity

• Published in: ESC Heart Failure 2022-06, Vol.9 (3), p.1914-1919
• Main Authors: Di Lisi, Daniela, Madaudo, Cristina, Alagna, Giulia, Santoro, Marco, Rossetto, Ludovico, Siragusa, Sergio, Novo, Giuseppina
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Adult; Age; Aged; Aspirin; Asymptomatic; Atherosclerosis; Blood pressure; Cancer; Cardiac arrhythmia; Cardiology; Cardiotoxicity - etiology; Cardiovascular prevention; Cardiovascular toxicity; Cardio‐oncology; Chronic Disease; Chronic myeloid leukaemia; Coronary vessels; Diabetes; Disease prevention; Family medical history; Female; Heart attacks; Heart failure; Heart Failure - complications; Heart Failure - epidemiology; Hematology; Humans; Inducible T-Cell Co-Stimulator Protein; Ischemia; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - complications; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Male; Middle Aged; Nilotinib; Oncology; Original; Ponatinib; Pulmonary hypertension; Retrospective Studies; Risk Assessment; Risk factors; Severe acute respiratory syndrome coronavirus 2; Targeted cancer therapy; Ultrasonic imaging; Vein & artery diseases
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.13897

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