{
  "abstract": "Background and Importance Treatment with trastuzumab may be associated in 10-20% of cases with the development of left ventricular dysfunction and progression to heart failure. Baseline cardiovascular risk (CR) stratification using the Heart Failure Association–International Cardio-Oncology Society (HFA-IC-OS) algorithm allows the identification of profiles of greater vulnerability before starting therapy.Aim and Objectives To analyse the relationship between baseline CR stratification according to the HFA-ICOS algorithm and the occurrence of cardiovascular events in patients treated with trastuzumab, as well as to describe the measures taken.Material and Methods Retrospective observational study in HER2-positive cancer patients treated with trastuzumab as the only cardiotoxic anti-HER2 agent in a tertiary hospital between January2024-June2025.Prior to treatment, demographic, clinical, and cardiac imaging variables were recorded, as well as comorbidities, lifestyle risk factors, and history of cardiotoxicity from previous or concomitant treatments. Baseline CR was stratified into low, moderate, high, or very high.A cardiovascular event was defined as a decrease in LVEF ≥10 points from baseline and/or a drop below 50%. After the event, management included cycle delay, initiation of cardiological treatment, or intensification of follow-up.Results The cohort included 81 patents (70 women, 11 men) whose mean age at baseline was 65 years (range: 29-89), in whom trastuzumab was used as treatment for breast cancer (82%) and gastroesophageal cancer (18%).Baseline risk distribution, clinical factors, and comorbidities, together with the relationship with previous and current treatments and cardiological evaluation, were analysed, and specific risk subgroups were identified. The results are summarised in table 1.During follow-up, 21% of patients experienced cardiovascular events, with a higher prevalence in those with high or very high baseline risk (73%). After the event occurred, different measures were taken according to clinical need: one-third of patients began cardiological treatment, almost half postponed the cycle, and all were reevaluated with LVEF before the next cycle.Abstract 4CPS-042 Table 1Conclusion and Relevance The fact that 40% of patients were classified as high or very high risk, together with the occurrence of a significant number of cardiovascular events, reinforces the need to link baseline stratification with clinical management. These findings demonstrate the usefulness of the HFA-ICOS algorithm in identifying risk profiles, prioritising cardiological surveillance, and guiding clinical decisions that ensure the continuity of cancer treatment.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital De Jaén, Farmacia Hospitalaria, Jaén, Spain"
      ],
      "name": "J Moreno Banegas"
    },
    {
      "affiliations": [
        "Hospital Universitario De Jaén, Farmacia Hospitalaria, Jaén, Spain"
      ],
      "name": "MD Córdoba Sotomayor"
    },
    {
      "affiliations": [
        "Hospital Universitario De Jaén, Farmacia Hospitalaria, Jaén, Spain"
      ],
      "name": "Á Moreno Lopez"
    },
    {
      "affiliations": [
        "Hospital Universitario De Jaén, Farmacia Hospitalaria, Jaén, Spain"
      ],
      "name": "MÁ Torrecilla Abril"
    }
  ],
  "title": "4CPS-042 From risk stratification to follow-up: prevalence and management of cardiovascular events associated with trastuzumab",
  "uid": "48c8420f-c5bf-54d6-b57e-12c89738ed4e"
}