ToolsCalculators
HFA-ICOS Baseline Cardio-Oncology Risk Assessment for VEGF Inhibitors
Baseline cardiotoxicity risk stratification before VEGF inhibitor therapy.
HFA-ICOS Baseline Cardio-Oncology Risk Assessment for VEGF Inhibitors
Existing heart failure or cardiomyopathy
Arterial vascular disease
Ischaemic heart disease, prior PCI/CABG, stable angina, TIA, stroke, or peripheral arterial disease.
Venous thrombosis (DVT or PE)
Baseline LVEF <50%
QTc ≥480 ms
Age ≥75 years
Hypertension
Prior anthracycline exposure
Borderline LVEF 50-54%
QTc 450-480 ms (men) or 460-480 ms (women)
Arrhythmia
Elevated baseline troponin
Elevated baseline BNP or NT-proBNP
Age 65-74 years
Diabetes mellitus
Hyperlipidaemia
Chronic kidney disease
Proteinuria
Prior radiotherapy to the left chest or mediastinum
Current smoker or significant smoking history
Obesity (BMI >30 kg/m²)
ResultLow risk
No or only a single medium-risk (1-point) factor is present. Routine baseline assessment is sufficient.
- Medium-risk points
- 0
- Overall risk category
- Low risk
When to use
- Baseline cardiovascular risk stratification before starting VEGF inhibitor therapy in patients with cancer.
- Determining how intensively to monitor cardiac function during treatment.
Formula
Overall risk = Very high if any very-high-risk criterion is present; otherwise High if any high-risk criterion is present OR medium-risk points total ≥5; otherwise Moderate if medium-risk points total 2-4; otherwise Low (0 or 1 medium-risk point). Medium-risk items are weighted 1 or 2 points as specified.
Pearls and pitfalls
- Any single very-high-risk criterion overrides the point total and classifies the patient as very high risk.
- Risk category is intended to guide referral to cardio-oncology and the frequency of on-treatment cardiac imaging/biomarker surveillance, not to withhold effective cancer therapy.