European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment

Author:

Lee G A1ORCID,Aktaa S234ORCID,Baker E1,Gale C P234,Yaseen Israa F56,Gulati G78ORCID,Asteggiano R910ORCID,Szmit S1112ORCID,Cohen-Solal A1314ORCID,Abdin A15,Jurczak W16,Garrido Lopez P17ORCID,Sverdlov A L18,Tocchetti C G19,Barac A20ORCID,Parrini I21,Zamorano P22,Iakobishvili Z2324,Pudil R25,Badimon L26,Kirby A M27,Blaes A H28ORCID,Farmakis D29ORCID,Curigliano G3031,Stephens R32,Lyon A R33,Lopez-Fernandez T34

Affiliation:

1. Division of Applied Technology for Clinical Care, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London , James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA , UK

2. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds , Leeds , UK

3. Leeds Institute for Data Analytics, University of Leeds , Leeds , UK

4. Department of Cardiology, Leeds Teaching Hospitals NHS Trust , Leeds , UK

5. Baghdad Heart Center, Baghdad Teaching Hospital, Medical City , Baghdad , Iraq

6. Scientific Council of Cardiology, Iraqi Board for Medical Specializations , Baghdad , Iraq

7. Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Division of Research and Innovation, Akershus University Hospital , Lørenskog , Norway

8. Department of Cardiology, Division of Medicine, Oslo University Hospital , Ullevål, Oslo , Norway

9. School of Medicine, Insubria University , Varese , Italy

10. LARC (Laboratorio Analisi e Ricerca Clinica) , C.so Venezia 10, Turin , Italy

11. Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education , Otwock , Poland

12. Institute of Hematology and Transfusion Medicine , Warsaw , Poland

13. Research Medical Unit INSERM U-942, University of Paris , Paris , France

14. Cardiology Department, Hôpitaux de Paris , Hôpital Lariboisière 2 Rue Ambroise Paré , Paris, France

15. Department of Internal Medicine III, Cardiology, Angiology, Intensive Care Medicine, Saarland University Medical Center , Homburg , Germany

16. MSC National Research Institute of Oncology , Garnarska 11, 31-115 Krakow , Poland

17. Jefe Servicio Oncología Médica, Hospital Universitario Ramón y Cajal , Madrid , Spain

18. Newcastle Centre of Excellence in Cardio-Oncology, Calvary Mater Newcastle, Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle , NSW , Australia

19. Cardio-Oncology Unit, Department of Translational Medical Sciences (DISMET), Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center for Clinical and Translational Research (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University , Naples , Italy

20. Cardio-oncology Program, MedStar Heart and Vascular Institute , Washington DC , USA

21. Department of Cardiology, Mauriziano Hospital , Turin , Italy

22. University Hospital Ramon y Cajal , Madrid , Spain

23. Department of Community Cardiology, Clalit Health Services, Tel Aviv Jaffa , Israel

24. Faculty of Health Sciences, Ben Gurion University of the Negev , Beersheba , Israel

25. University Hospital Hradec Králové , Sokolská 5005, Hradec Králové , Czech Republic

26. IIBSant Pau, Hospital de la Santa Creu i Sant Pau, CiberCV , Barcelona , Spain

27. Royal Marsden NHS Trust & Institute of Cancer Research , London , UK

28. Division of Hematology/Oncology/Transplantation, University of Minnesota , Minneapolis, MN , USA

29. University of Cyprus Medical School , Nicosia , Cyprus

30. Department of Oncology and Hemato-Oncology, University of Milan , Milan , Italy

31. IRCCS, European Institute of Oncology , Milan , Italy

32. Patient Advocate , London , UK

33. National Heart and Lung Institute, Imperial College London, and Cardio-Oncology Service, Royal Brompton Hospital , London , UK

34. Cardiology department, La Paz University Hospital, IdiPAZ Research Institute , Madrid , Spain

Abstract

Abstract Aims To develop quality indicators (QIs) for the evaluation of the prevention and management of cancer therapy-related cardiovascular toxicity. Methods and results We followed the European Society of Cardiology (ESC) methodology for QI development which comprises (i) identifying the key domains of care for the prevention and management of cancer therapy-related cardiovascular toxicity in patients on cancer treatment, (ii) performing a systematic review of the literature to develop candidate QIs, and (iii) selecting of the final set of QIs using a modified Delphi process. Work was undertaken in parallel with the writing of the 2022 ESC Guidelines on Cardio-Oncology and in collaboration with the European Haematology Association, the European Society for Therapeutic Radiology and Oncology and the International Cardio-Oncology Society. In total, 5 main and 9 secondary QIs were selected across five domains of care: (i) Structural framework, (ii) Baseline cardiovascular risk assessment, (iii) Cancer therapy related cardiovascular toxicity, (iv) Predictors of outcomes, and (v) Monitoring of cardiovascular complications during cancer therapy. Conclusion We present the ESC Cardio-Oncology QIs with their development process and provide an overview of the scientific rationale for their selection. These indicators are aimed at quantifying and improving the adherence to guideline-recommended clinical practice and improving patient outcomes.

Funder

Horizon 2020

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Health Policy

Reference19 articles.

1. Evaluation and management of cancer patients presenting with acute cardiovascular disease: a consensus document of the Acute CardioVascular Care (ACVC) association and the ESC council of Cardio-Oncology—Part 1: acute coronary syndromes and acute pericardial diseases;Gevaert;EHJ Acute CV Care,2021

2. Evaluation and management of cancer patients presenting with acute cardiovascular disease: a Consensus Document of the Acute CardioVascular Care (ACVC) association and the ESC council of Cardio-Oncology - Part 2: Acute Heart Failure, Acute myocardial diseases, Acute Venous Thromboembolic Diseases and Acute Arrhythmias;Gevaert;EHJ Acute CV Care,2022

3. ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC);Zamorano;Eur Heart J,2016

4. European Society of Cardiology methodology for the development of quality indicators for the quantification of cardiovascular care and outcomes;Aktaa;Eur Heart J Qual Care Clin Outcomes,2022

5. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS): Developed by the task force on cardio-oncology of the European Society of Cardiology (ESC);Lyon;EHJ,2022

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