Observations from clinics, institutions and cardio-oncology services. OBELISCO II EXTENSION

Abstract Background OBELISCO is the first national cardio-oncology registry in a South American country that provides information about the status of cardio-oncology in our country. OBELISCO II EXTENSION was designed to update this information after the publication of the 2022 European Society of Cardiology (ESC) guidelines on cardio-oncology. Purpose To evaluate the use of the ESC risk assessment tool, compare cardiovascular risk factors control with that reported in OBELISCO, and determine follow-up of survivors, associated conditions, referrals from centers without cardio-oncology services and importance of a multidisciplinary approach. Methods Public and private general hospitals that participated in the OBELISCO registry were surveyed. The poll included 17 structured questions responded by either a cardiologist, oncologist or hematologist. Data were collected and managed using REDCap (Research Electronic Data Capture, a web-based software platform). Results Of the 51 centers surveyed, 49% do not have cardio-oncology services but 60% of cardiologists with advanced knowledge of cardiotoxicity manage cancer patients, 28% refer them to cardio-oncology specialists, and 12% do not refer them; 42.1% of oncologists/hematologists always refer their patients to cardio-oncologists. Most cardiologists (61%) consider that they do not evaluate all the patients requiring assessment and 53.6% of them believe that the main reason is lack of referral; 96.0% of cardiologists would like to know about current services and 92.0% find online consultations useful when referring the patient is not possible; 92% know how to assess cardiovascular risk but only 59% actually do so versus 27% in the previous OBELISCO registry (Figure). All the respondents agree with the importance of controlling risk factors: 89.8% recommend smoking cessation, 95.8% encourage physical activity and 97.9% encourage weight loss in overweight or obese patients. Only 18.4% refer to a nutritionist while 67.3% suggest psychological support. The most common cancers in our country are breast, prostate, lung and colon cancer for 60% of the respondents and 46% report that the most prevalent associations are ventricular dysfunction with breast cancer (58%) and prostate cancer with hypertension and dyslipidemia (46%). Most respondents (75.5%) follow up survivors, and 93.4% believe that a multidisciplinary approach is the best strategy for decision-making in oncological patients with coronary artery disease. Conclusions In our country, general cardiologists are involved in the care of cancer patients in most cases, but they recognize the need for a national cardio-oncology network to improve clinical results. Since the publication of the risk score proposed by the ESC, more cardiologists in our country are involved in cardiovascular risk assessment particularly using this tool, recommend control of cardiovascular risk factors, follow up survivors and believe in a multidisciplinary approach.Cardiovascular Risk Assessment