Baseline Cardiovascular Risk Assessment in Cancer Patients Scheduled to Receive Cardiotoxic Cancer Therapies (Anthracycline Chemotherapy) – Online Calculator

Nataliia Lopina July 3, 2023

Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies (Anthracycline Chemotherapy) from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society (HFA-ICOS).

Risk factors	Score	Level of evidence
Previous cardiovascular disease
Heart failure or cardiomyopathy	Very high	B
Severe valvular heart disease	High	C
Myocardial infraction or previous coronary revascularization (PCI or CABG)	High	C
Stable angina	High	C
Baseline LVEF <50%	High	B
Borderline LVEF 50-54%	Medium²	C
Cardiac biomarkers (where available)
Elevated baseline troponin	Medium¹	C
Elevated baseline BNP or NT-proBNP	Medium¹	C
Demographic and cardiovascular risk factors
Age ≥80 years	High	B
Age 65–79 years	Medium_²	B
Hypertension	Medium¹	B
Diabetes mellitus	Medium¹	C
Chronic kidney disease	Medium¹	C
Previous cardiotoxic cancer treatment
Previous anthracycline exposure	High	B
Prior radiotherapy to left chest or mediastinum	High	C
Previous non-anthracycline-based chemotherapy	Medium¹	C
Lifestyle risk factors
Current smoker or significant smoking history	Medium¹	C
Obesity (BMI >30 kg/m²)	Medium¹	C

BMI, body mass index; BNP, brain natriuretic peptide; CABG, coronary artery bypass graft; LVEF, left ventricular ejection fraction; NT-proBNP, N-terminal pro-brain natriuretic peptide; PCI, percutaneous coronary intervention
^a Elevated above the upper limit of normal for local laboratory reference range.
^b Systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg, or on treatment.
^c Glycated haemoglobin >7.0% or >53 mmol/mol, or on treatment.
^d Estimated glomerular filtration rate <60 mL/min/1.73 m².

HFA-ICOS risk assessment

no risk factor OR one medium¹ risk factor	Low risk	<2%
medium risk factors with a total of 2–4 points	Medium risk	2-9%
medium risk factors with a total of ≥5 points OR any high risk factor	High risk	10-19%
any very high risk factor	Very high risk	>20%