在癌症幸存者中比较心力衰竭风险评估工具
Cheng Hwee Soh1,2, Thomas H Marwick3,4,5,6
1Imaging Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Cardio-oncology (London, England)
|October 11, 2024
概括
在癌症幸存者中,心力衰竭 (HF) 风险计算器HFA-ICOS和ARIC-HF与PCP-HF相比显示出类似的,优异的性能. 建议进一步开发癌症特异性HF预测工具,以改善预防.
科学领域:
- 心脏瘤学 - 心脏瘤学
- 心血管疾病流行病学
- 癌症的生存率 癌症的生存率
背景情况:
- 癌症幸存者面临心力衰竭 (HF) 的高风险,由于共同的风险因素和心脏毒性癌症治疗.
- 有效的HF查依赖于准确的风险评估,但对幸存者的最佳方法仍然不清楚.
- 这项研究比较了癌症幸存者群体中现有的HF风险计算器的性能.
研究的目的:
- 评估和比较三种HF风险计算器在癌症幸存者的预测准确度.
- 确定最有效的风险评估工具来分层这一群体中的HF风险.
- 为癌症幸存者制定有针对性的HF预防策略提供信息.
主要方法:
- 利用英国生物库数据,通过ICD-10代码识别癌症幸存者和非癌症对照.
- 评估使用心力衰竭协会-国际心脏瘤学会 (HFA-ICOS),社区动脉样硬化风险 (ARIC-HF) 和聚合队列方程预防心力衰竭 (PCP-HF) 评分的事件HF风险.
- 使用曲线下的面积 (AUC) 进行预测性能比较,以年龄和性别进行倾向匹配.
主要成果:
- 与PCP-HF (AUC 0.717) 相比,HFA-ICOS (AUC 0.753) 和ARIC-HF (AUC 0.757) 显示出与PCP-HF (AUC 0.717) 相似的和更高的歧视事件HF.
- 所有测试的风险计算器在乳腺癌或淋巴瘤以外的癌症类型的幸存者中表现更好.
- 该研究包括9,232名乳腺癌/淋巴瘤幸存者和23,800名其他癌症类型的幸存者.
结论:
- 在癌症幸存者和对照人群中,HFA-ICOS和ARIC-HF风险计算器在预测癌症幸存者和对照人群中的事件HF方面表现优于PCP-HF.
- 虽然所有模型都显示出适度的歧视,但癌症特异性HF预测工具可以增强预防工作.
- 优化HF风险评估对于癌症幸存者的主动心血管护理至关重要.
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