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. Author manuscript; available in PMC: 2021 Dec 1.
Published in final edited form as: Eur J Heart Fail. 2020 Oct 2;22(12):2290–2309. doi: 10.1002/ejhf.1985

Table 2.

Baseline risk factors for cardiotoxicity3,10,23–28

Demographic factors

  • Age: <10 years, >65 years

  • African ethnicity
Lifestyle factors

  • Smoking

  • High alcohol intake

  • Sedentary lifestyle
Patient history factors

  • Positive family history of premature CVD (<50 years of age)

  • Family history of sudden death (occult familial dilated cardiomyopathy, rare variants in cardiomyopathy-associated genes, congenital LQTS)

  • Comorbidities:
    • Atherothrombotic disease
    • Diabetes mellitus
    • Dyslipidaemia
    • Electrolyte imbalance
    • Hypercholesterolaemia
    • Hypothyroidism

  • Reports of syncope

  • History of VTE, inherited thrombophilia

  • History of transfusions

  • Impaired hepatic drug metabolism CVAD

  • Elevated cardiac biomarkers
    • Hypertension
    • Impaired renal function, CKD, renal failure
    • Infection
    • Obesity
    • Pulmonary disease
Treatment-related factors

  • Prior anthracycline use (including dose, and formulation)

  • Prior RT, especially to chest or mediastinum

  • Hormone agent use

  • Erythropoiesis stimulating agents use

  • QT-prolonging agent use
CV-related factors

  • HF with preserved or reduced ejection fraction

  • Asymptomatic LV dysfunction (LVEF <50%)

  • Evidence of CAD (previous myocardial infarction, angina, PCI or CABG, myocardial ischaemia)

  • Moderate and severe VHD with LVH or LV impairment

  • Hypertensive heart disease with LV hypertrophy

  • Cardiomyopathy (hypertrophic, dilated, or restrictive)

  • Significant cardiac arrhythmias (e.g. AF, AV block, ventricular tachyarrhythmias), QTc prolongation
Cancer-related factors

  • Primary cancer site (mostly pancreatic, brain, stomach, kidney, lung, lymphoma, myeloma)

  • Histology (especially adenocarcinoma)

  • Advanced stage (metastatic)

  • Initial period after cancer diagnosis

  • Low performance status

AF, atrial fibrillation; AV, atrioventricular; CABG, coronary artery bypass graft; CAD, coronary artery disease; CKD, chronic kidney disease; CV, cardiovascular; CVAD, central venous access device; CVD, cardiovascular disease; HF, heart failure; LQTS, long QT syndrome; LV, left ventricular; LVEF, left ventricular ejection fraction; LVH, left ventricular hypertrophy; PCI, percutaneous coronary intervention; RT, radiotherapy; VHD, valvular heart disease; VTE, venous thromboembolism.