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Evaluation of cardiovascular events in patients with hepatocellular carcinoma treated with sorafenib in the clinical practice. The CARDIO‐SOR study
Author(s) -
CarballoFolgoso Lorena,
ÁlvarezVelasco Rut,
Lorca Rebeca,
CastañoGarcía Andrés,
Cuevas Javier,
GonzálezDiéguez María Luisa,
Martín María,
ÁlvarezNavascués Carmen,
Cadahía Valle,
Morís César,
Rodríguez Manuel,
Varela María
Publication year - 2021
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14941
Subject(s) - mace , medicine , hepatocellular carcinoma , sorafenib , adverse effect , heart failure , incidence (geometry) , cirrhosis , acute coronary syndrome , dyslipidemia , diabetes mellitus , retrospective cohort study , cardiology , myocardial infarction , disease , conventional pci , physics , optics , endocrinology
Background and Aims The effectiveness of systemic treatment in advanced hepatocellular carcinoma (HCC) depends on the selection of patients, management of cirrhosis complications and expertise to treat adverse events. The aims of the study are to assess the frequency and management of cardiovascular events in HCC patients treated with sorafenib (SOR) and to create a scale to predict the onset of major adverse cardiovascular events (MACE). Method Observational retrospective study with consecutive HCC patients treated with SOR between 2007 and 2019 in a western centre. In order to classify cardiovascular risk pre‐SOR, we designed the CARDIOSOR scale with age, hypertension, diabetes, dyslipidaemia and peripheral vascular disease. Other adverse events, dosing and outcome data were collected during a homogeneous protocolled follow‐up. Results Two hundred ninety‐nine patients were included (219 BCLC‐C). The median overall survival was 11.1 months (IQR 5.6‐20.5), and duration of treatment was 7.4 months (IQR 3.3‐14.7). Seventeen patients (6%) stopped SOR due to cardiovascular event. Thirty‐three patients suffered MACE (7 heart failure, 11 acute coronary syndrome, 12 cerebrovascular accident and 8 peripheral vascular ischemia); 99 had a minor cardiovascular event, mainly hypertension (n = 81). Age was the only independent factor associated to MACE (HR 1.07; 95% CI 1.03‐1.12; P = .002). The CARDIOSOR scale allows to identify the group of patients with higher risk of MACE (sHR 3.4; 95% CI 1.4‐6.7; P = .04). Conclusion The incidence of cardiovascular events in HCC patients treated with SOR is higher than expected. Multidisciplinary approach and clinical tools like CARDIOSOR scale could be helpful to manage these patients.