Cardiovascular risk factors in oncology: A cross-sectional analysis of patients undergoing chemo-radiotherapy at a tertiary care center

Cancer and cardiovascular disease are leading causes of death in developed countries. Advances in cancer treatment have improved survival but increased cardiovascular morbidity and mortality among survivors, making cardiovascular disease the second leading cause of death in this group. In Colombia, data on chemotherapy-related cardiotoxicity are scarce, though it affects an estimated 27% of patients. The role of risk factors in cardiological follow-up and patient care remains unclear. This study aimed to identify and assess prevalent cardiovascular risk factors, using the Mayo score, in cancer patients at a tertiary care center.

To describe the most prevalent cardiovascular risk factors in a cohort of 500 cancer patients treated with chemotherapy and radiotherapy at our hospital, Colombia, between 2019 and 2021.

A retrospective, observational, cross-sectional study was conducted among 348 patients aged 18 years or older with cancer who received chemotherapy, including anthracyclines, between 2019 and 2021. Cardiotoxicity risk was calculated using the Mayo score. Patients were categorized based on their Mayo score and baseline cardiovascular risk factors.

The study included 348 cancer patients who underwent chemotherapy, of whom 217 were women. Cardiotoxicity risk was assessed using the Mayo score, and patients were classified accordingly: 69 patients (19.8%) as very high risk, 25 (7.1%) as high risk, 96 (27.5%) as intermediate risk, and 158 (45%) as low or very low risk. Key cardiotoxicity risk factors from the Mayo score included hypertension, type 2 diabetes, and a history of coronary or peripheral artery disease, with most patients in the intermediate risk category.

Among those treated with anthracyclines, 98% were in the very high-risk group, indicating that anthracyclines significantly increase cardiotoxicity risk. Additional cardiovascular risk factors, such as dyslipidemia, chronic kidney disease, and obesity, were prevalent, particularly in the intermediate risk group.

This study highlights the high prevalence of cardiovascular risk factors in cancer patients undergoing chemotherapy, who often present multiple traditional risk factors. The Mayo score indicates most patients are at intermediate risk of cardiotoxicity, with those receiving anthracyclines at significantly higher risk. Common conditions like hypertension, diabetes, coronary artery disease, and obesity emphasize the need for individualized cardiological follow-up. While economic and follow-up challenges persist, tools like the Mayo score help identify high-risk patients, making preventive and therapeutic strategies essential to reducing cardiovascular morbidity and mortality in cancer survivors.

Conflicts of interest: Nothing to declare.

Mayo distribution with risk factors