Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model
BackgroundMultiple myeloma (MM) is the second most common hematological malignancy, and the treatments markedly elevate the survival rate of the patients in recent years. However, the prevalence of cardiovascular adverse events (CVAEs) in MM had been increasing recently. CVAEs in MM patients are an...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1043869/full |
| _version_ | 1797866810448543744 |
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| author | Shuai Yuan Jie-Yi Zhou Ben-Zhao Yang Zhong-Lei Xie Ting-Jun Zhu Hui-Xian Hu Rong Li Rong Li |
| author_facet | Shuai Yuan Jie-Yi Zhou Ben-Zhao Yang Zhong-Lei Xie Ting-Jun Zhu Hui-Xian Hu Rong Li Rong Li |
| author_sort | Shuai Yuan |
| collection | DOAJ |
| description | BackgroundMultiple myeloma (MM) is the second most common hematological malignancy, and the treatments markedly elevate the survival rate of the patients in recent years. However, the prevalence of cardiovascular adverse events (CVAEs) in MM had been increasing recently. CVAEs in MM patients are an important problem that we should focus on. Clinical tools for prognostication and risk-stratification are needed.Patients and methodsThis is a retrospective study that included patients who were newly diagnosed with multiple myeloma (NDMM) in Shanghai Changzheng Hospital and Affiliated Jinhua Hospital, Zhejiang University School of Medicine from June 2018 to July 2020. A total of 253 patients from two medical centers were divided into training cohort and validation cohort randomly. Univariable analysis of the baseline factors was performed using CVAEs endpoints. Multivariable analysis identified three factors for a prognostic model that was validated in internal validation cohorts.ResultsFactors independently associated with CVAEs in NDMM were as follows: age>61 years old, high level of baseline office blood pressure, and left ventricular hypertrophy (LVH). Age contributed 2 points, and the other two factors contributed 1 point to a prognostic model. The model distinguished the patients into three groups: 3–4 points, high risk; 2 points, intermediate risk; 0–1 point, low risk. These groups had significant difference in CVAEs during follow-up days in both training cohort (p<0.0001) and validation cohort (p=0.0018). In addition, the model had good calibration. The C-indexes for the prediction of overall survival of CVAEs in the training and validation cohorts were 0.73 (95% CI, 0.67–0.79) and 0.66 (95% CI, 0.51–0.81), respectively. The areas under the receiver operating characteristic curve (AUROCs) of the 1-year CVAEs probability in the training and validation cohorts were 0.738 and 0.673, respectively. The AUROCs of the 2-year CVAE probability in the training and validation cohorts were 0.722 and 0.742, respectively. The decision-curve analysis indicated that the prediction model provided greater net benefit than the default strategies of providing assessment or not providing assessment for all patients.ConclusionA prognostic risk prediction model for predicting CVAEs risk of NDMM patients was developed and internally validated. Patients at increased risk of CVAEs can be identified at treatment initiation and be more focused on cardiovascular protection in the treatment plan. |
| first_indexed | 2024-04-09T23:31:20Z |
| format | Article |
| id | doaj.art-e8ef280d71f2483e98a5b9d85f1e77c0 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T23:31:20Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-e8ef280d71f2483e98a5b9d85f1e77c02023-03-21T05:45:49ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.10438691043869Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic modelShuai Yuan0Jie-Yi Zhou1Ben-Zhao Yang2Zhong-Lei Xie3Ting-Jun Zhu4Hui-Xian Hu5Rong Li6Rong Li7Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nuclear Radiation Injury Protection and Treatment Department, Naval Medical Center, Naval Medical University, Shanghai, ChinaDepartment of Cardiology, Naval Medical Center, Naval Medical University, Shanghai, ChinaShanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, ChinaDepartment of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, ChinaDepartment of Nuclear Radiation Injury Protection and Treatment Department, Naval Medical Center, Naval Medical University, Shanghai, ChinaDepartment of Hematology, The Myeloma and Lymphoma Center, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, ChinaBackgroundMultiple myeloma (MM) is the second most common hematological malignancy, and the treatments markedly elevate the survival rate of the patients in recent years. However, the prevalence of cardiovascular adverse events (CVAEs) in MM had been increasing recently. CVAEs in MM patients are an important problem that we should focus on. Clinical tools for prognostication and risk-stratification are needed.Patients and methodsThis is a retrospective study that included patients who were newly diagnosed with multiple myeloma (NDMM) in Shanghai Changzheng Hospital and Affiliated Jinhua Hospital, Zhejiang University School of Medicine from June 2018 to July 2020. A total of 253 patients from two medical centers were divided into training cohort and validation cohort randomly. Univariable analysis of the baseline factors was performed using CVAEs endpoints. Multivariable analysis identified three factors for a prognostic model that was validated in internal validation cohorts.ResultsFactors independently associated with CVAEs in NDMM were as follows: age>61 years old, high level of baseline office blood pressure, and left ventricular hypertrophy (LVH). Age contributed 2 points, and the other two factors contributed 1 point to a prognostic model. The model distinguished the patients into three groups: 3–4 points, high risk; 2 points, intermediate risk; 0–1 point, low risk. These groups had significant difference in CVAEs during follow-up days in both training cohort (p<0.0001) and validation cohort (p=0.0018). In addition, the model had good calibration. The C-indexes for the prediction of overall survival of CVAEs in the training and validation cohorts were 0.73 (95% CI, 0.67–0.79) and 0.66 (95% CI, 0.51–0.81), respectively. The areas under the receiver operating characteristic curve (AUROCs) of the 1-year CVAEs probability in the training and validation cohorts were 0.738 and 0.673, respectively. The AUROCs of the 2-year CVAE probability in the training and validation cohorts were 0.722 and 0.742, respectively. The decision-curve analysis indicated that the prediction model provided greater net benefit than the default strategies of providing assessment or not providing assessment for all patients.ConclusionA prognostic risk prediction model for predicting CVAEs risk of NDMM patients was developed and internally validated. Patients at increased risk of CVAEs can be identified at treatment initiation and be more focused on cardiovascular protection in the treatment plan.https://www.frontiersin.org/articles/10.3389/fonc.2023.1043869/fullmultiple myelomacardiovascular adverse eventsprediction modeltreatment plancardiovascular protection |
| spellingShingle | Shuai Yuan Jie-Yi Zhou Ben-Zhao Yang Zhong-Lei Xie Ting-Jun Zhu Hui-Xian Hu Rong Li Rong Li Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model Frontiers in Oncology multiple myeloma cardiovascular adverse events prediction model treatment plan cardiovascular protection |
| title | Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model |
| title_full | Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model |
| title_fullStr | Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model |
| title_full_unstemmed | Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model |
| title_short | Prediction of cardiovascular adverse events in newly diagnosed multiple myeloma: Development and validation of a risk score prognostic model |
| title_sort | prediction of cardiovascular adverse events in newly diagnosed multiple myeloma development and validation of a risk score prognostic model |
| topic | multiple myeloma cardiovascular adverse events prediction model treatment plan cardiovascular protection |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1043869/full |
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