Table 2.

Pretreatment recommendations

Initial workup

Comprehensive patient history

Blood pressure measurement

Electrocardiogram

Concomitant medications

CV risk factor assessment: the presence of diabetes, obesity, hypertension, dyslipidemia, chronic renal disease

History of valvular heart disease

History of arrhythmias, heart failure, or left ventricular dysfunction/reduced ejection fraction

History of ischemic heart disease

For patients with high CV risk or established CV disease

Echocardiogram

Baseline cardiac biomarkers

Consider using FRS-CVD65 score for stratification

Treatment selection

Patients with no CV risk factors

Any approved BTKi

If other safety concerns, favor more selective drugs (acalabrutinib or zanubrutinib) or Bcl-2 inhibitors

Patients with CV risk (eg, well-controlled AF, HTN)

Consider second-generation BTKis (acalabrutinib or zanubrutinib)

FRS-CVD, Framingham risk score-cardiovascular disease.