Abstract Background Cardio-oncology plays a crucial role in mitigating cardiovascular risks associated with cancer therapies. Current guidelines emphasize cardiotoxicity prevention in hematologic malignancies, where heart failure incidence can reach 30% in high-risk patients, and cardiovascular-related hospitalizations range between 20-30%. In 2024, at our Department, a dedicated outpatient cardio-oncology service was implemented, operating via direct referrals, enhancing collaboration between specialists. The model was structured following international recommendations and best practices from established centers to ensure efficiency and sustainability. Methods Between January and December 2024, 622 patients underwent baseline cardiovascular screening and were enrolled in a risk-stratified follow-up program. A tailored risk assessment model was developed, integrating intrinsic risk factors (SCORE-2, SCORE2- OP, Clinical Frailty Scale, HFA-ICOS, and BMT risk scores) and extrinsic therapy-specific risks (e.g., anthracyclines, immune checkpoint inhibitors, CAR-T therapies). Based on this classification, patients were assigned structured follow-up schedules, incorporating clinical and echocardiographic assessments for early cardiotoxicity detection. A high-risk subgroup (120 patients) underwent intensified surveillance. Instead of relying solely on heart failure biomarkers, a comprehensive clinical and echocardiographic strategy was prioritized, utilizing Global Longitudinal Strain (GLS) on a standardized ultrasound platform for data consistency. Urgent assessments were available in addition to scheduled follow-ups. Cardioprotective strategies and diagnostic workups followed international protocols. Results Among 622 patients, 11 required emergency cardiovascular evaluations: see Abstract Picture 1 No cardiovascular-related deaths were recorded. The only fatality occurred in the patient with subarachnoid hemorrhage, highlighting the importance of proactive cardiovascular monitoring in these patients. Conclusions The integrated cardio-oncology model enabled early cardiotoxicity detection, reduced emergency visits, and enhanced resource efficiency. Strengthening collaboration between hematologists and cardiologists resulted in optimized patient care and improved outcomes through proactive risk-stratified monitoring.Picture 1 - Results
Caciolli et al. (Fri,) studied this question.