Cardio-oncology最新文献

{"title":"Cardio-oncology from the consulting side: diagnostic thresholds, surveillance and treatment responsibility among cardiologists and internists in a German multicentre survey.","authors":"Sebastian Poley, Lorena Payo-Anez, Felix M Heidrich, Karim Ibrahim, Marian Christoph, Tina Haase, Jan Hamann, Lorenz Harst, Silvio Quick","doi":"10.1186/s40959-026-00588-7","DOIUrl":"10.1186/s40959-026-00588-7","url":null,"abstract":"<p><strong>Background: </strong>Cancer therapy-related cardiovascular toxicity (CTR-CVT) is a leading non-cancer cause of morbidity and mortality. The 2022 ESC Guidelines define a multidisciplinary pathway in which baseline cardiovascular risk assessment is led by the treating oncology or haematology team, with cardiological involvement guided by the resulting risk; how this is put into practice in hospitals is poorly characterised. Previous surveys have described the treating specialties; we examined the receiving cardiologists and internists.</p><p><strong>Methods: </strong>Cross-sectional online survey of physicians in cardiology, internal medicine, gynaecology and oncology at 1,435 German hospital departments (February-October 2025). This pre-specified analysis addressed cardiological involvement in the pathway and in risk stratification, left-ventricular ejection fraction (LVEF)-decline thresholds, strain use and biomarker testing in a standardised high-risk scenario (a patient with pre-existing heart failure receiving anthracycline chemotherapy). Findings are self-reported; comparisons exploratory.</p><p><strong>Results: </strong>One hundred twenty physicians responded (44 cardiologists, 28 oncologists, 27 gynaecologists, 21 internists; 73.3% academic or university hospitals). Risk stratification showed the lowest cardiological involvement (42.9%, 15/35); 51.0% (26/51) of cardiologists and internists performed it themselves or within a team, and 19.6% (10/51) regarded it as the treating oncologist's task. LVEF-decline thresholds were asked in two non-equivalent versions and are reported separately. Any LVEF decline was regarded as cardiotoxicity by 38.2% (13/34) of cardiologists and 61.5% (8/13) of internists, and by 26.7% (4/15) of gynaecologists and 39.1% (9/23) of oncologists; a decline exceeding 10% points by 55.9% and 23.1%, respectively. Routine strain use was reported by 76.5% (26/34) of cardiologists and 36.4% (4/11) of internists. Twelve-month biomarker testing in this scenario was infrequent even in cardiology (20.6%).</p><p><strong>Conclusions: </strong>Among these predominantly academic physicians, risk stratification had the least clearly assigned ownership, the LVEF decline regarded as relevant varied widely within each version, routine strain use differed between cardiology and internal medicine, and late post-treatment biomarker testing was infrequent even in cardiology. These hypothesis-generating findings identify targets-assigned responsibility for risk stratification, explicit LVEF thresholds, implementation of routine strain imaging and structured post-treatment surveillance-whose effect on CTR-CVT outcomes requires prospective testing.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex cardiac overlap: immune checkpoint inhibitor myocarditis in hypertrophic obstructive cardiomyopathy with subsequent NSTEMI.","authors":"Ahmed Basuoni, Marwa Makhlouf, Waleed Dawelbeit, Yasir AlMalki, Noof Alkharousi, Arif Albulushi, Aref Zribi, Zamzam Al-Hashami","doi":"10.1186/s40959-026-00587-8","DOIUrl":"10.1186/s40959-026-00587-8","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare but life-threatening complication, particularly challenging to diagnose in patients with coexisting cardiac conditions. A 58-year-old man with advanced oropharyngeal carcinoma treated with pembrolizumab presented with heart failure symptoms and markedly elevated troponin levels. Imaging revealed hypertrophic obstructive cardiomyopathy (HOCM) alongside cardiac magnetic resonance findings consistent with ICI-associated myocarditis. He initially responded to high-dose corticosteroids but relapsed due to non-adherence, requiring re-treatment and addition of mycophenolate mofetil. Following recovery, he developed a significant rise in troponin with new regional wall motion abnormalities. Coronary angiography demonstrated significant coronary artery disease, supporting the diagnosis of acute coronary syndrome in the context of the clinical presentation, biomarker elevation, and imaging findings, managed with percutaneous coronary intervention. Post-procedural hypotension was attributed to adrenal insufficiency and resolved with stress-dose corticosteroids. Follow-up imaging demonstrated features of both prior myocarditis and new ischemic injury. The patient improved clinically after PCI and was discharged with normalized troponin levels.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic and therapeutic challenges of ICI-associated myocarditis in the presence of overlapping cardiac pathologies. Multimodality imaging and clinical context are essential for accurate diagnosis, and alternative causes of troponin elevation must be carefully excluded.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of prophylactic cardioprotection in early-stage breast cancer patients on non-anthracycline anti-HER2 therapy.","authors":"Thomas Q McClelland, Ikeoluwapo Kendra Bolakale-Rufai, Meng Zhiying, Abigail S Baldridge, Nausheen Akhter","doi":"10.1186/s40959-026-00581-0","DOIUrl":"https://doi.org/10.1186/s40959-026-00581-0","url":null,"abstract":"<p><p>Anti-HER2 therapy has improved survival in HER2-positive breast cancer patients for decades but is associated with well-established cardiotoxicity. Our prior randomized controlled trial PROTECT HER2 found no short-term benefit of prophylactic beta-blocker cardio protection (CPT) based on changes in global longitudinal strain (GLS) in a breast cancer population treated with non-anthracycline anti-HER2 therapies. The long-term cardiovascular (CV) effects of CPT remain unknown. Utilizing the PROTECT HER2 cohort with 5-10 years follow-up, we performed a post hoc analysis to assess long-term outcomes. We evaluated the incidence of major adverse cardiovascular events (MACE; defined as all-cause mortality, stroke, myocardial infarction (MI), heart failure hospitalization (HFH), and significant arrhythmias) based on CPT. We also assessed associations between CV risk factors (hypertension, hyperlipidemia, diabetes and BMI≥25 kg/m²) and the occurrence of MACE. Among 109 patients the mean (SD) age was 51 (11) years, and the median (IQR) follow up was 7 (6-9) years post-RCT. Eight (7.3%) patients developed a total of 10 events, including 3 (2.8%) non-CV mortalities, 1 (0.9%) non-fatal stroke, and 6 (5.5%) arrhythmias. There were no significant associations observed between CV risk factors and MACE overall. However, 40% of patients (44/109) developed at least one new CV risk factor during follow-up. These findings demonstrate that while prophylactic CPT did not significantly impact long-term CV outcomes, a substantial proportion developed new risk factors over time, highlighting an important area for longitudinal risk monitoring and intervention.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery calcification score as a prognostic factor in patients undergoing allogeneic stem cell transplantation - a retrospective analysis.","authors":"Hans-Jonas Meyer, Anar Aghayev, Narmin Nasibova, Felix Barajas Ordonez, Jan Borggrefe, Alexey Surov","doi":"10.1186/s40959-026-00555-2","DOIUrl":"10.1186/s40959-026-00555-2","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcification (CAC) scoring can be measured as a by-product of computed tomography (CT). CAC scoring reflects the general cardiovascular risk profile of patients. The aim of the present study was to determine the prognostic role of CAC on overall survival (OS) in patients with different hematological diseases undergoing allogeneic stem cell transplantation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on all patients undergoing peripheral blood stem cell transplantation between January 2015 and October 2021. A total of 121 patients (68 male patients, 56.1%) with a mean age of 53.1 ± 13.6 years were identified in the data base and included into the present study. The clinical CT scan to rule out infectious foci was used to assess the CAC score for each patient. The semiquantitative Weston score was measured to quantify CAC.</p><p><strong>Results: </strong>A total of 67 patients (54.9%) died during the course of the study. A total of 52 patients (42.6%) had visible calcifications on CT images, whereas 70 patients (57.4%) had no calcifications (CAC score 0). There was no association between the CAC score with OS, with an HR of 1.14 (95% CI 0.89; 1.45), p = 0.28) as a metric variable and HR of 1.33 (95% CI 0.82; 2.15) as a dichotomized variable (CAC score 0 versus positive CAC score). There was no association between CAC score and occurrence of sepsis or graft-versus host disease after transplantation.</p><p><strong>Conclusions: </strong>The presence of CT-defined coronary calcifications has no prognostic relevance in patients undergoing allogeneic stem cell therapy. The impact of CT-defined cardiovascular risk factors appears to be relatively modest in this heterogeneous patient sample.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The growing need for heart failure specific risk prediction models and standardized care pathways in patients with cancer.","authors":"Arianne Clare Agdamag, Wilson Tang","doi":"10.1186/s40959-026-00563-2","DOIUrl":"10.1186/s40959-026-00563-2","url":null,"abstract":"<p><p>Cardiovascular disease remains the leading cause of morbidity and mortality among cancer survivors. Multiple cardiovascular risk prediction models exist to provide risk stratification for patients who are about to undergo cancer treatment. Current risk models have limited guidance on how to prevent, modify, and monitor for heart failure (HF) particularly heart failure with preserved ejection fraction (HFpEF). Cancer survivors are at an elevated risk for HFpEF due to the development of cardiometabolic syndrome associated with aging and long-term survival. Future efforts should focus on novel biomarkers in assessing HF, development of large, multicenter databases that can be used to validate models across diverse populations, and defining clear treatment pathways once risk is identified. A more comprehensive and inclusive risk stratification model with pragmatic approaches to clinical care will allow for more widespread use among cardiologists and oncologists.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer treatment-related cardiovascular toxicity according to the ESC definition in patients receiving CAR T-cell therapy.","authors":"Jakob Christoph Voran, Carolin Richard, Astrid Dempfle, Christiane Pott, Philipp Nakov, Guranda Chitadze, Natalie Schub, Catrin Meyer, Hatim Seoudy, Derk Frank, Claudia D Baldus, Oliver J Müller, David Baden","doi":"10.1186/s40959-026-00544-5","DOIUrl":"10.1186/s40959-026-00544-5","url":null,"abstract":"<p><strong>Background: </strong>Chimeric antigen receptor (CAR) T-cell therapy has substantially improved outcomes in refractory hematologic malignancies but may cause cardiovascular complications, particularly in the context of cytokine release syndrome (CRS). Real-world data on incidence, severity, and prognostic relevance of cancer therapy-related cardiovascular toxicity (CTR-CVT) defined by the 2022 ESC cardio-oncology guidelines remain in the context of CAR-T cell therapy limited.</p><p><strong>Methods: </strong>This retrospective single-center study includes 104 patients treated with CAR T-cells between 09/2019 and 02/2024 for acute lymphoblastic leukemia, non-Hodgkin lymphoma and multiple myeloma. The primary endpoint was new-onset CTR-CVT during hospital stay, defined as cancer therapy-related cardiac dysfunction (CTRCD), arrhythmia, myocardial infarction, cardiogenic shock, or cardiovascular death. Clinical characteristics, biomarkers, echocardiographic parameters, CRS/ICANS severity, and survival outcomes were analyzed.</p><p><strong>Results: </strong>Fifty-two patients (50%) met criteria for CTR-CVT, predominantly due to asymptomatic biomarker elevation. CTRCD occurred in 48.1%, whereas clinically significant events were rare: three patients developed symptomatic CTRCD, one experienced cardiogenic shock, and no myocardial infarctions or cardiovascular deaths were observed. Cardiovascular events occurred early and were associated with higher-grade CRS and ICANS, as well as elevated inflammatory markers. Reduced baseline left ventricular ejection fraction, elevated systolic pulmonary artery pressure, impaired performance status, and beta-blocker use were associated with increased CTR-CVT risk. Survival was numerically lower in patients with CTR-CVT but did not reach statistical significance.</p><p><strong>Conclusion: </strong>Although half of patients fulfilled ESC criteria for CTR-CVT, clinically relevant cardiac events after CAR T-cell therapy were uncommon. These findings suggest potential overclassification driven by biomarker elevations and underscore the importance of emphasizing clinical relevance when assessing cardiotoxicity in CAR T-cell recipients.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance status and outcomes in patients with cancer receiving thromboprophylaxis: a subanalysis of the AVERT trial.","authors":"Nicola Potere, Yan Xu, Ranjeeta Mallick, Tzu-Fei Wang, Danny Hill, Alejandro Lazo-Langner, Vicky Tagalakis, Sudeep Shivakumar, Marcello Di Nisio, Philip S Wells, Marc Carrier","doi":"10.1186/s40959-026-00542-7","DOIUrl":"https://doi.org/10.1186/s40959-026-00542-7","url":null,"abstract":"<p><strong>Background: </strong>The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is central to cancer care planning and prognostication. Whether ECOG-PS also carries prognostic value in the setting of primary thromboprophylaxis for cancer-associated venous thromboembolism (VTE) remains unknown.</p><p><strong>Objectives: </strong>To evaluate the impact of ECOG-PS on clinical outcomes in ambulatory patients with cancer initiating chemotherapy.</p><p><strong>Methods: </strong>This was a post-hoc analysis of the AVERT randomized controlled trial that evaluated apixaban (2.5 mg twice daily) for thromboprophylaxis in patients at intermediate-to-high VTE risk. Multivariable survival models assessed the association between ECOG-PS (0-1 versus 2-3) and the composite primary outcome of VTE or clinically relevant bleeding (CRB), as well as its individual components and all-cause mortality, over 180 days.</p><p><strong>Results: </strong>Of 428 patients included, 368 (86.0%) and 60 (14.0%) had an ECOG-PS of 0-1 and 2-3, respectively. The primary composite outcome occurred in 12.8% (n = 47) in those with ECOG 0-1 and 18.3% (n = 11) with ECOG-PS 2-3 (6-month cumulative incidence: 13.0% [95% CI: 9.8%-16.7%] versus 19.9% [95% CI: 10.5%-31.4%], respectively). Worse performance status was associated with higher risks for the composite outcome (aHR: 1.76; 95% CI: 1.14-2.72; p = 0.011), CRB (aHR: 1.58; 95%CI: 1.53-1.63; p < 0.0001), and all-cause mortality (aHR: 5.77; 95% CI: 4.98-6.67; p < 0.0001). In exploratory treatment-effect analyses, apixaban reduced VTE risk across ECOG-PS strata, including among participants with ECOG-PS 2-3, without clear evidence of excess CRB in this subgroup.</p><p><strong>Conclusions: </strong>ECOG-PS predicts VTE-related outcomes in ambulatory patients with cancer and may inform individualized, value-based shared decision-making regarding anticoagulant thromboprophylaxis.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICU-onset atrial fibrillation surrogate, thrombocytopenia, and short-term outcomes in patients with cancer requiring intensive care: a retrospective ICU cohort study.","authors":"Hasan Burak Isleyen, Sevil Tugrul Yavuz, Sercan Bulut, Fatih Kizkapan, Cevahir Alioglu, Erdem Sunger, Ertugrul Okuyan","doi":"10.1186/s40959-026-00548-1","DOIUrl":"10.1186/s40959-026-00548-1","url":null,"abstract":"<p><strong>Background: </strong>Cancer and atrial fibrillation frequently coexist. Intensive care adds hemodynamic stress, organ failure, and competing bleeding risk. Whether platelet-defined thrombocytopenia modifies the association between an ICU-onset atrial fibrillation surrogate and short-term outcomes in patients with cancer remains uncertain.</p><p><strong>Methods: </strong>We performed a secondary analysis of a retrospective ICU cohort derived from MIMIC-IV version 3.1, a de-identified critical care database with date-shifted patient timelines. Adult ICU stays with solid or hematologic malignancy were included. The exposure was an ICU-onset AF surrogate rather than adjudicated incident AF. Early thrombocytopenia was defined from the minimum platelet count within 48 h and categorized as > = 150, 100-149, 50-99, and < 50 × 10^9/L. The primary outcome was in-hospital death. Secondary outcomes were 28-day death, major bleeding identified by ICD coding, and ischemic stroke identified by ICD coding. Multivariable logistic regression tested AF-by-platelet interaction. Sensitivity models added available cancer-site, cardiovascular comorbidity, major surgery, structured anticancer medication indicators, and anticoagulation dose-class variables.</p><p><strong>Results: </strong>Among 9,640 cancer ICU stays, 1,788 (18.5%) met criteria for the ICU-onset AF surrogate. In-hospital death occurred in 1,724 stays (17.9%), 28-day death in 2,394 (24.8%), ICD-coded major bleeding in 1,001 (10.4%), and ICD-coded ischemic stroke in 410 (4.3%). In primary complete-case interaction models (n = 9,505), the AF-by-platelet interaction for in-hospital death was borderline (P = 0.069), with the largest mortality signal in the platelet < 50 × 10^9/L stratum (adjusted OR 1.61, 95% CI 1.09-2.37). This signal persisted after expanded adjustment (adjusted OR 1.54, 95% CI 1.04-2.27) and anticoagulation dose-class adjustment (adjusted OR 1.50, 95% CI 1.01-2.22). For ICD-coded major bleeding, the interaction was significant in the primary model (P = 0.040) and remained similar after expanded adjustment (P = 0.050); the platelet 50-99 × 10^9/L stratum showed lower adjusted odds, a finding interpreted as exploratory.</p><p><strong>Conclusions: </strong>In this cancer ICU cohort, an ICU-onset AF surrogate was associated with short-term outcome patterns that differed across platelet strata. Severe thrombocytopenia marked the subgroup with the clearest mortality signal. Because AF, bleeding, and stroke were defined from structured data rather than adjudicated events, the findings should be interpreted as hypothesis-generating.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable machine learning for cardiovascular disease risk prediction in cancer survivors: development and internal validation.","authors":"Guoxing Zhang, Xueying Zhang, Chunyi Jia, Huanyu Zhou, Xiaojia Sun, Haifeng Liu","doi":"10.1186/s40959-026-00547-2","DOIUrl":"10.1186/s40959-026-00547-2","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a major concern among cancer survivors. However, the intersection of cancer and CVD has only recently gained broader attention, and substantial evidence gaps remain. This study aimed to identify risk factors associated with incident CVD in cancer survivors and to develop a machine learning model for CVD risk prediction.</p><p><strong>Methods: </strong>In this retrospective study, we included 2,500 patients receiving systemic antitumor therapy at Jilin Cancer Hospital; 188 incident CVD events were observed. Variables spanning demographic, clinical, tumor- and treatment-related, and laboratory domains were collected. The dataset was randomly split into a training set (75%) and an internal validation set (25%). Feature selection was performed using LASSO regression. Six prediction models were developed, including five machine learning algorithms (GBM, CoxBoost, XGBoost, SVM, and RSF) and a traditional Cox proportional hazards model. Model performance was evaluated using time-dependent receiver operating characteristic curves (AUC), calibration analyses, and decision curve analysis. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>In univariate analyses, 48 variables were associated with CVD risk (P < 0.20). LASSO regression identified 19 predictors for model development. Key predictors included elevated systolic blood pressure, specific cancer types, anthracycline use, and a history of hypertension. The XGBoost model demonstrated the best predictive performance, with an average AUC of 0.666, sensitivity of 69.8%, specificity of 60.7%, and overall accuracy of 61.4% in the internal validation set. The model showed good calibration and yielded a positive net benefit across a range of clinical thresholds. SHAP analysis indicated that cancer type, lack of anti-HER2 therapy, elevated systolic blood pressure, advanced T stage, advanced TNM stage, and higher uric acid levels were the most influential predictors.</p><p><strong>Conclusion: </strong>This study developed and internally validated interpretable machine learning models to predict CVD risk among cancer survivors. The models demonstrated good discrimination and calibration and outperformed traditional methods. By enabling individualized risk quantification and providing transparent interpretation of key predictors, this approach offers a practical tool to support personalized surveillance and prevention strategies in cardio-oncology.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of myocardial infarction and ischemic stroke in pelvic cancer surgery.","authors":"Nicola Giudici, Johan Björklund, Renata Zelic, Per Henrik Vincent, Simone Scuderi, Peter Wiklund, Markus Aly, Olof Akre, Juhana Rautiola","doi":"10.1186/s40959-026-00545-4","DOIUrl":"10.1186/s40959-026-00545-4","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction and ischemic stroke are common causes of morbidity after major cancer surgery. Understanding the risks associated with both open and laparoscopic surgery is crucial in reducing postoperative morbidity and mortality.</p><p><strong>Methods: </strong>This nationwide cohort study included patients who underwent major cancer surgery in the pelvis from 2000 to 2015. The primary outcome was the incidence of myocardial infarction and ischemic stroke within 90 days postoperatively. Adjusted odds ratios (OR) were estimated using logistic regression adjusted for propensity score and risks by regression standardization.</p><p><strong>Results: </strong>A total of 22,619 patients operated with laparoscopic and 70,896 patients operated with open approach were included in the analysis. The crude 90-day cumulative risks of myocardial infarction and ischemic stroke were 0.66% and 0.48%, respectively. Laparoscopic surgery was associated with lower odds of myocardial infarction within 30 days (OR 0.39, 95% CI 0.23-0.62) and 90 days (OR 0.57, 95% CI 0.41-0.81) compared to open surgery. Similarly, an association was observed for ischemic stroke (OR 0.67, 95% CI 0.38-1.05 at 30 days; OR 0.69, 95% CI 0.45-0.80 at 90 days).</p><p><strong>Conclusions: </strong>Laparoscopic surgery is associated with reduced postoperative risk of myocardial infarction and ischemic stroke compared to open surgery in the treatment of pelvic cancers. These findings favor the broader adoption of minimally invasive techniques in clinical practice.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}