High blood pressure, Scarff Bloom-Richardson grade 3 predict CV events in breast cancer

Pre-existing cardiovascular disease (CVD) and grade 3 Scarff Bloom-Richardson are associated with the occurrence of cardiovascular (CV) events among women with breast cancer, reports a study.

The findings suggest the need to assess the performance of risk prediction models such as Abdel-Qadir score coupled with other factors such as Scarff Bloom and Richardson grading in order to identify patients at high risk of experiencing cardiotoxicity.

A team of investigators obtained the medical records and baseline characteristics of patients diagnosed with breast cancer from 2010 to 2011 in a French comprehensive cancer centre. CV events were characterized by arterial and cardiac events, atrial fibrillation, and venous thromboembolism occurring during the 5-year follow-up.

The investigators used Abdel-Qadir multivariable prediction model for major adverse CV events with the concordance index (c-index) score to assess calibration by comparing predicted risks to observed probabilities.

Of the 943 breast cancer patients identified, 83 (8.8 percent) presented with at least one CV event, leading to a cumulative incidence of 0.07 at 5 years (95 percent confidence interval [CI], 0.055‒0.088). The cumulative incidence of atrial fibrillation at 5 years was 0.01 (95 percent CI, 0.005‒0.018).

Pre-existing CVDs including high blood pressure (hazard ratio [HR], 1.78, 95 percent CI, 1.07‒2.97; p=0.028), acute coronary syndrome (HR, 5.28, 95 percent CI, 2.16‒12.88; p<0.05), and grade 3 Scarff Bloom-Richardson (HR, 1.95, 95 percent CI, 1.21‒3.15; p=0.006) significantly correlated with the occurrence of CV events.

“With a c-index inferior to 0.7, the Abdel-Qadir score was not fully validated in our population,” the investigators said.