Abstract 43P
Background
Breast cancer survival is improving due to combination therapy. However, in the long term, patients may experience negative effects on cardiovascular function. The Framingham score (FRS) provides an estimate of the risk of developing a cardiovascular event, and stratifies patients into low-, intermediate, or high-risk groups. The aim of this study is to evaluate the power of the FRS to predict long-term cardiotoxicity.
Methods
We used echocardiography to evaluate cardiac function in women who had already been treated in our department at least two years ago. FRS was estimated by a validated risk calculator. Patients were stratified into low (<10%), intermediate (10-20%) and high (≥20%) risk groups. Cardiotoxicity was defined by presence of symptomatic congestive heart failure (CHF) or a drop of 5% or more in the left ventricular ejection fraction (LVEF) value without clinical symptoms of CHF.
Results
One hundred Forty-three patients were evaluated for cardiotoxicity after a median follow-up of 9 years (range from 2 to 22 years). 99 patients (69%) were classified as low-risk; 31 (22%) as intermediate risk; and 13 (9%) were classified as high risk. Patients had received multimodal treatment (Anthracyclines:100%, Docetaxel:62,9%, Endocrine therapy: 72%, Trastuzumab: 7%, Radiotherapy: 83,2%). 39 women (28,3%) developed cardiotoxicity, of whom Only one developed symptomatic CHF. Cardiotoxicity was significantly higher in high-risk than in low risk patients (odds ratio: 4,912; 95% confidence interval: 1,48-16,30). ANOVA analysis revealed that Linear regression analysis was statistically significant: High FRS was associated with cardiotoxicity (p = 0.001).
Conclusions
Estimation of baseline FRS is of paramount importance; it can predict the risk of cardiotoxicity in long-term cancer survivors. It can be used to perform a baseline risk stratification, to allow personalized cardiac monitoring, and why not to guide cardioprotective therapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.