Background: Despite the inference about the cardiotoxicity induced by Carfilzomib, no validated risk prediction models for adverse cardiovascular events in a real-life population are available. Objectives: The aim of this study was to evaluate the performance of the risk stratification score for Carfilzomib-induced cardiotoxicity of the Heart Failure Association of the European Society of Cardiology and the International Cardio-Oncology Society (HFA-ICOS) in patients with multiple myeloma (MM). Methods: This is a prospective, real-world study including MM patients consecutively enrolled prior to starting Carfilzomib, divided into levels of risk according to the HFA-ICOS proforma. Results: Of 169 patients, 11.8% were classified as ‘low risk’, 38.5% as ‘medium risk’, 45.6% as ‘high risk’ and 4.1% as ‘very high risk’ at baseline. A total of 89 (52.7%) patients experienced one of the following events: 36 (21.3%) had at least one cardiovascular event and 77 (45.6%) had almost one hypertension-related event. No significant differences were observed for the incidence of any cardiovascular events between the different levels of risk (p> 0.05), even considering the HFA-ICOS score as a continuous variable. The integration of the score with the baseline systolic blood pressure and pulse wave velocity enhanced the accuracy of the score (AUC 0.557 vs. 0.736). Conclusions: The HFA-ICOS score did not discriminate between patients at low, medium and high risk, showing a limited discriminatory power in predicting the risk of events in our population. The integration of other parameters in the HFA-ICOS score, such as systolic blood pressure and pulse wave velocity, improved the performance of the score.
背景：尽管已有关于卡非佐米诱导心脏毒性的推断，但在真实世界人群中尚无经过验证的不良心血管事件风险预测模型。目的：本研究旨在评估欧洲心脏病学会心力衰竭协会与国际心脏肿瘤学会（HFA-ICOS）制定的卡非佐米诱导心脏毒性风险分层评分在多发性骨髓瘤患者中的预测效能。方法：本研究为前瞻性真实世界研究，连续纳入开始卡非佐米治疗前的多发性骨髓瘤患者，根据HFA-ICOS风险分层表进行风险分级。结果：在169例患者中，基线时11.8%被归类为"低风险"，38.5%为"中风险"，45.6%为"高风险"，4.1%为"极高风险"。共89例（52.7%）患者发生以下至少一种事件：36例（21.3%）出现至少一次心血管事件，77例（45.6%）发生至少一次高血压相关事件。不同风险等级间心血管事件发生率无显著差异（p>0.05），即使将HFA-ICOS评分作为连续变量分析亦如此。将基线收缩压和脉搏波速度纳入评分体系后，评分准确性得到提升（AUC从0.557提高至0.736）。结论：HFA-ICOS评分未能有效区分低、中、高风险患者，在本研究人群中预测事件风险的区分能力有限。将收缩压和脉搏波速度等其他参数整合入HFA-ICOS评分体系可改善其预测性能。
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