Baseline Cardiovascular Risk Assessment in Cancer Patients Scheduled to Receive Cardiotoxic Cancer Therapies (Anthracycline Chemotherapy) – Online Calculator
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 | Medium2 | 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 |
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% |
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