p.19 抽出テキスト

calculators (e.g. SMART [Second manifestations of arterial disease] risk score, ADVANCE [Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation] risk score, SCORE2 [Systematic Coronary Risk Estimation 2], SCORE2-OP [Systematic Coronary Risk Estimation 2—Older Persons], ASCVD [AtheroSclerotic Cardiovascular Disease] risk score, U-Prevent, and lifetime risk calculators) may be considered at baseline for the assessment of CV risk, considering that cancer itself may increase the likelihood of CVD.19,23,30,31

Baseline risk assessment should be considered by the treating oncology or haematology team for all patients diagnosed with cancer who are scheduled to receive a cancer treatment identified to have a clinically significant level of CRT-CVT, or by a cardiologist if appropriate. In the case of patients scheduled to receive

Current cancer treatment Dexamethasone . 160 mg/ month – – – – M1 – Includes anthracycline before HER2-targeted therapy – M1g – – – – Previous exposure to Anthracycline H M2h H – H H Trastuzumab – VH – – – – RT to left chest or mediastinum H M2 M1 – M1 M2 Non-anthracycline chemotherapy M1 – – – – – Lifestyle risk factors Current smoker or significant smoking history M1 M1 M1 H M1 M1 Obesity (BMI . 30 kg/m2) M1 M1 M1 M1 M1 M1 © ESC 2022

AF, atrial fibrillation; BCR-ABL, breakpoint cluster region–Abelson oncogene locus; BMI, body mass index; BNP, B-type natriuretic peptide; BP, blood pressure; CABG, coronary artery bypass graft; cTn, cardiac troponin; CTRCD, cancer therapy-related cardiac dysfunction; CV, cardiovascular; CVD, cardiovascular disease; CVRF, cardiovascular risk factors; DM, diabetes mellitus; DVT, deep vein thrombosis; eGFR, estimated glomerular filtration rate; H, high risk; HbA1c, glycated haemoglobin; HER2, human epidermal receptor 2; HF, heart failure; IMiD, immunomodulatory drugs; LV, left ventricular; LVEF, left ventricular ejection fraction; M, moderate risk; MEK, mitogen-activated extracellular signal-regulated kinase; MI, myocardial infarction; MM, multiple myeloma; NP, natriuretic peptides (including BNP and NT-proBNP); NT-proBNP, N-terminal pro-B-type natriuretic peptide; PCI, percutaneous coronary intervention; PE, pulmonary embolism; PH, pulmonary hypertension; PI, proteasome inhibitors; QTc, corrected QT interval; RAF, rapidly accelerated fibrosarcoma; RT, radiotherapy; TKI, tyrosine kinase inhibitors; ULN, upper limit of normal; VEGFi, vascular endothelial growth factor inhibitors; VH, very high risk; VHD, valvular heart disease. An expanded version of this table is provided in Supplementary data, Tables S2–S7. Risk level: Low risk = no risk factors OR one moderate1 risk factor; moderate risk (M) = moderate risk factors with a total of 2–4 points (Moderate 1 [M1] = 1 point; Moderate [M2] = 2 points); high risk (H) = moderate risk factors with a total of ≥5 points OR any high-risk factor; very-high risk (VH) = any very-high risk factor. aAF, atrial flutter, ventricular tachycardia, or ventricular fibrillation. bElevated above the ULN of the local laboratory reference range. cSystolic BP . 140 mmHg or diastolic BP . 90 mmHg, or on treatment. deGFR , 60 mL/min/1.73 m2. eHbA1c . 7.0% or .53 mmol/mol, or on treatment. fNon-high density lipoprotein cholesterol .3.8 mmol/L (.145 mg/dL) or on treatment. gHigh risk if anthracycline chemotherapy and trastuzumab delivered concurrently. hPrevious malignancy (not current treatment protocol).

Table 5 Anthracycline equivalence dose

Doxorubicin Epirubicin Daunorubicin Mitoxantrone Idarubicina

CV toxicity dose ratio 1 0.8 0.6 10.5 5 Isoequivalent dose 100 mg/m2 125 mg/m2 167 mg/m2 9.5 mg/m2 20 mg/m2 © ESC 2022

This table refers to anthracycline equivalence dose using doxorubicin as a reference. Note that these isoequivalent doses are derived from paediatric CS. CS, cancer survivors; CV, cardiovascular. aData for idarubicin are based upon an estimated anticancer efficacy ratio, not derived from cardiotoxicity data. The CV toxicity dose ratio provides the value that should be used to multiply the dose of the anthracycline of interest to convert to isoequivalent doses of doxorubicin; e.g. to convert 125 mg/m2 of epirubicin to doxorubicin isoequivalent, multiply the dose by 0.8 (125 mg/m2 × 0.8 = 100 mg/m2 of doxorubicin). Downloaded from academic.oup.com/eurheartj/article/43/41/4229/6673995 by guest on 07 October 2026