Key result
Cardiovascular risk software calculator predicts cardiac events with ~0.89 AUC.
Why the study?
A simplified method for rapid assessment of cardiovascular risk in breast cancer patients undergoing radiation therapy, without requiring special equipment or a cardiologist, needed to be developed and validated.
Does a simplified software calculator accurately predict and stratify cardiovascular event risk in breast cancer patients undergoing radiation therapy?
Cohort (n=125)
No
Does a simplified software calculator accurately predict and stratify cardiovascular event risk in breast cancer patients undergoing radiation therapy?
A rapid 4.2-minute software calculator using mean heart radiation dose accurately stratifies 2-year cardiac event risk in breast cancer patients without requiring specialized equipment or cardiologist involvement.
May enable rapid cardiac risk stratification in breast cancer RT; leaves open external validation before clinical adoption.
Objective. To develop and validate a simplified method for rapid assessment of cardiovascular risk in oncology patients with breast cancer (BC), which does notrequire special equipment or the involvement of a cardiologist. Material and methods. The method is based on a systematic analysis of 93 publications (>50.000 patients) and uses the HR coefficient of 1.21 for every 1 Gy of average heart dose, which is based on the central estimate of the range of modern studies: the fundamental study by Darby et al. (2013) — HR=1.074/Gr; Chung et al. (2021) — HR=1.23/Gr; Van den Bogaard et al. (2021) — HR=1.269/Gr; average of the range: (1.165+1.269)÷2=1.217≈1.21. A software calculator has been created. A prospective single-center validation study was conducted at the Voronezh Regional Research and Clinical Oncology Center (n=125 patients, median follow-up of 24 months). Results. The calculator demonstrated excellent prognostic accuracy in the single- center study: AUC=0.89 (95%CI: 0.85—0.93), good calibration (Hosmer—Lemeshow test p = 0.137). Three-level risk stratification showed a cardiac event rate of 2.6% in the low-risk group, 14.7% in the moderate-risk group, and 78.6% in the high-risk group (p<0.001). The time spent by a physician to assess risks using the software calculator is 4.2 minutes. Conclusion. The developed software calculator demonstrated high efficacy in a single-center study. For its widespread implementation in Russian clinical practice, a multicenter study involving oncology institutions from various federal districts is necessary.
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Андреева et al. (2026) conducted a cohort in Breast cancer undergoing radiation therapy (n=125). Software calculator for cardiovascular risk assessment (using HR 1.21 per 1 Gy of average heart dose) vs. Three-level risk stratification groups (low, moderate, high risk) was evaluated on Prognostic accuracy for cardiac events (AUC 0.89, 95% CI 0.85-0.93, p=<0.001). The cardiovascular risk software calculator achieved an AUC of 0.89 (95% CI 0.85-0.93) and stratified cardiac event rates from 2.6% (low-risk) to 78.6% (high-risk; p<0.001).
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