Table 3.
Integer risk scores for survivors across 5-year age categories associated with cardiovascular outcomes and corresponding model discrimination and predictive power at and through age 50 years*
| Characteristic | Heart failure |
Ischemic heart disease |
Stroke |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age 20 y | Age 25 y | Age 30 y | Age 35 y | Age 20 y | Age 25 y | Age 30 y | Age 35 y | Age 20 y | Age 25 y | Age 30 y | Age 35 y | |
| Sex | ||||||||||||
| Male | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 0 | 0† | 0 | 1 |
| Female | 1 | 1† | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Age at diagnosis, y | ||||||||||||
| <5 | 1† | 2† | 2† | 2 | N/A | N/A | N/A | N/A | 1 | 1† | 1 | 1† |
| 5–9 | 1 | 1† | 0 | 0 | N/A | N/A | N/A | N/A | 1† | 1† | 1 | 1 |
| 10–14 | 0 | 0† | 0 | 0 | N/A | N/A | N/A | N/A | 0 | 0 | 0 | 0 |
| ≥15 | 0 | 0 | 0 | 0 | N/A | N/A | N/A | N/A | 0 | 0 | 0 | 0 |
| Alkylator | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 0 | 1† | 1† | 1 |
| Anthracycline, mg/m2 | ||||||||||||
| None | 0 | 0 | 0 | 0 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| <100 | 0 | 0† | 0 | 0 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| 100–249 | 3 | 3 | 2† | 2 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| ≥250 | 4 | 4 | 4† | 4 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Cranial radiation‡, Gy | ||||||||||||
| None | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 0 | 0 | 0 | 0 |
| <20 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 0 | 0 | 0 | 0 |
| 20–29 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 0 | 1 | 1 | 3 |
| 30–49 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 4 | 4 | 4† | 4 |
| ≥50 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 4 | 4 | 4 | 4 |
| Chest radiation, Gy | ||||||||||||
| None | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| <5 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 5–14 | 1 | 1† | 1 | 0 | 1 | 2 | 3 | 4 | 0 | 0 | 0 | 0 |
| 15–34 | 2 | 2† | 2 | 2† | 2† | 3 | 4 | 4 | 0 | 0 | 0 | 0 |
| ≥35 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 1 | 1 | 1 | 1 |
| Cardiovascular risk factors | ||||||||||||
| Diabetes | 3 | 2 | 2† | 2† | 3 | 3† | 2 | 1 | 0 | 0 | 1† | 3 |
| Dyslipidemia | 2 | 1† | 0 | 0 | 0 | 1 | 1† | 1 | 1 | 1 | 2† | 2 |
| Hypertension | 3† | 1† | 1† | 1 | 2† | 2 | 2† | 2† | 1 | 1† | 2† | 2† |
| Discovery cohort | ||||||||||||
| AUC, age 50 y | 0.76 | 0.73 | 0.67 | 0.70 | 0.73 | 0.73 | 0.72 | 0.75 | 0.74 | 0.72 | 0.64 | 0.64 |
| C-statistic, age 50 y | 0.79 | 0.75 | 0.69 | 0.74 | 0.72 | 0.74 | 0.74 | 0.78 | 0.76 | 0.75 | 0.67 | 0.70 |
| Replication cohort | ||||||||||||
| AUC, age 50 y | 0.77 | 0.67 | 0.69 | 0.67 | 0.70 | 0.70 | 0.72 | 0.71 | 0.73 | 0.63 | 0.64 | 0.70 |
| C-statistic, age 50 y | 0.78 | 0.71 | 0.75 | 0.69 | 0.69 | 0.72 | 0.74 | 0.73 | 0.75 | 0.66 | 0.70 | 0.72 |
*
Risk scores 0, 1, 2, 3, and 4 correspond to rate ratios <1.3, 1.3 to 1.9, 2.0 to 2.9, 3.0 to 4.9, and ≥5.0, respectively. AUC = area under the receiver operating characteristic curve; C = concordance; N/A = characteristic not applicable for a given model.
†
Risk scores that were adjusted to improve their internal consistency, either across age time points and/or by characteristic categories.
‡
Cranial radiation exposure was considered only for the stroke outcome models.