Zhongguo aizheng zazhi (Jan 2022)

Validation of a scale for evaluating the cardiovascular risk after breast cancer therapy: the clinical scale for breast cancer treatment related cardiovascular toxicity

  • ZHANG Chi, CHEN Jiahui, LIN Jinyi, WANG Yan, ZHANG Sijia, ZHU Wei, CHENG Leilei

DOI
https://doi.org/10.19401/j.cnki.1007-3639.2022.01.007
Journal volume & issue
Vol. 32, no. 1
pp. 54 – 60

Abstract

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Background and purpose: The treatment-related cardiovascular disease in patients with breast cancer poses a greater mortality threat than cancer itself. To assist clinical oncologist, we introduced a scale to help clinicians by screening out patients with breast cancer who were at risk of cardiovascular diseases. The breast cancer patients in Zhongshan Hospital, Fudan University were analyzed retrospectively by the scale. Methods: This was a single center, retrospective trial. A total of 760 patients who met the inclusion and exclusion criteria were enrolled in this trial from January 1, 2017 to December 31, 2018. The incidence rate of cardiovascular risk was collected from patients eligible for admission. Secondly, follow-up information for each patient was evaluated by the scale and the clinician. The repeatability, sensitivity, specificity and consistency of the scale were evaluated. Results: The average follow-up duration was (746.55±309.94) d, and the average population age was (56.60±12.62) years. A total of 36 patients developed severe arrhythmias during or after the treatment, 8 patients with emerging myocardial injury and 6 patients with emerging cardiac insufficiency. The follow-up rates of patients with test for NT-proBNP from half a year to one year and more than one year after baseline were 34.31% and 29.62%, while 35.48% and 32.48% for those who took echocardiography. The sensitivity, specificity and overall accuracy of medium-and high-risk patient tests were 0.828, 0.934 and 0.921, respectively. The sensitivity, specificity and overall accuracy of high-risk patient tests were 0.983, 0.986, and 0.986, respectively. The linear consistency with clinical judgment was κ=0.633, P<0.05. The average time for completion of the scale was (108.67±44.86) s. Conclusion: The incidence rate of cardiovascular disease in breast cancer patients is even higher than that of cancer itself. Therefore, it is essential to monitor cardiovascular disease. In this trial, we provide a simple and feasible scale, which has high accuracy, specificity and convenience. We hope to promote it as soon as possible.

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