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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Kraler, S; Liberale, L; Nopp, S; Englisch, C; Grilz, E; Lapikova-Bryhinska, T; Akhmedov, A; Carbone, F; Ramoni, D; Tirandi, A; Scuricini, A; Isoppo, S; Tortorella, C; La, Rosa, F; Michelauz, C; Frè, F; Gavoci, A; Lisa, A; Suter, TM; von, Eckardstein, A; Wenzl, FA; Pabinger, I; Lüscher, TF; Montecucco, F; Ay, C; Moik, F.
Biomarker-enhanced cardiovascular risk prediction in patients with cancer: a prospective cohort study.
J Thromb Haemost. 2024; 22(11):3125-3136
Doi: 10.1016/j.jtha.2024.07.019
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
- Kraler Simon
- Co-authors Med Uni Graz
- Moik Florian
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- Abstract:
- BACKGROUND: Continuously improving cancer-specific survival puts a growing proportion of cancer patients at risk of major adverse cardiovascular events (MACE), but tailored tools for cardiovascular risk prediction remain unavailable. OBJECTIVES: To assess a broad panel of cardiovascular biomarkers and risk factors for the prediction of MACE and cardiovascular death in cancer patients. METHODS: In total, 2192 patients with newly diagnosed or recurrent cancer were followed prospectively for the occurrence of 2-year MACE and 5-year cardiovascular death. Univariable and multivariable risk models were fit to assess independent associations of cardiovascular risk factors and biomarkers with adverse outcomes, and a risk score was developed. RESULTS: Traditional cardiovascular risk factors and selected cancer types were linked to higher MACE risk. While levels of Lp(a), CRP, and GDF-15 did not associate with MACE, levels of ICAM-1, P-/E-/L-selectins, and NT-proBNP were independently linked to 2-year MACE risk. A clinical risk score was derived, assigning +1 point for male sex, smoking, and age of ≥60 years and +2 points for atherosclerotic disease, yielding a bootstrapped C-statistic of 0.76 (95% CI: 0.71-0.81) for the prediction of 2-year MACE. Implementation of biomarker data conferred improved performance (0.83, 95% CI: 0.78-0.88), with a simplified model showing similar performance (0.80, 95% CI: 0.74-0.86). The biomarker-enhanced and simplified prediction models achieved a C-statistic of 0.82 (95% CI: 0.71-0.93) and 0.74 (95% CI: 0.64-0.83) for the prediction of 5-year cardiovascular death. CONCLUSION: Biomarker-enhanced risk prediction strategies allow the identification of cancer patients at high risk of MACE and cardiovascular death. While external validation studies are ongoing, this first-of-its-kind risk score may provide the basis for personalized cardiovascular risk assessment across cancer entities.
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- Cardiovascular Diseases - blood, mortality, diagnosis
- Neoplasms - blood, diagnosis, mortality, complications
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- C-reactive protein
- growth differentiation factor 15
- major adverse cardiovascular events
- N-terminal pro-BNP
- personalized risk assessment
- precision medicine
- prevention