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Cardiac Imaging and Diagnostics / Lung Cancer Research Studies / Chemotherapy-induced Cardiotoxicity and Mitigation · Journal article
European Heart Journal Supplements · August 1, 2026
Early or partial results. Treat as a signal, not a conclusion.
This interim analysis of an ongoing prospective trial demonstrates 100% concordance between an automated digital tool and manual HFA-ICOS score calculation for cardiotoxicity risk stratification in 20 anthracycline-treated patients. The finding supports the technical accuracy of automated ESC guideline implementation but represents preliminary evidence from a very small sample; clinical outcome validation and the full planned 600-patient cohort are required to establish clinical utility.
Prospective multicentre cohort study with tool validation. Patients followed in cardio-oncology outpatient clinics treated with anthracyclines or anti-HER2 therapies, managed in accordance with ESC cardio-oncology recommendations.. Intervention: Automated digital consultation tool performing real-time cardiotoxicity risk stratification based on HFA-ICOS score. Compared with: Manual calculation of HFA-ICOS risk stratification using ESC Pocket Guidelines application or ESC guidelines. n = 20. Multicentre (centres not specified); European study under ESC framework.
100% concordance between automated and manual HFA-ICOS risk stratification (20 patients) Risk distribution: 8 patients low risk, 4 moderate risk, 8 high risk (automated assessment) Interim enrolment 23 patients at abstract submission; 20 eligible for HFA-ICOS analysis
No validation against clinical cardiotoxicity outcomes or long-term follow-up data reported.
The perfect concordance supports adoption of the automated tool as a practical aid for implementing ESC guideline-based risk stratification in clinical practice, potentially reducing heterogeneity across Europe. However, clinicians should await full trial completion and validation against clinical outcomes before relying solely on automated assessment for surveillance decisions.
Small ongoing trial (n=20 analysed at interim) with perfect concordance between automated and manual risk stratification, but insufficient data and no clinical outcome validation to support practice change.
As stated by the source record.
Quoted from the source exactly as published.
The perfect concordance supports adoption of the automated tool as a practical aid for implementing ESC guideline-based risk stratification in clinical practice, potentially reducing heterogeneity across Europe. However, clinicians should await full trial completion and validation against clinical outcomes before relying solely on automated assessment for surveillance decisions.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background/Introduction The European Society of Cardiology (ESC) cardio-oncology guidelines were published in 2022 and represent a cornerstone document aimed at harmonising and optimising cardiovascular care in patients with cancer (1). These recommendations provide a detailed framework for baseline cardiovascular risk stratification, particularly for therapies associated with cardiotoxicity such as anthracyclines. However, despite their comprehensive nature, real-time assessment of cardiotoxicity risk during routine clinical consultations may be perceived as complex and challenging to implement in daily practice with significant heterogeneity across Europe. Purpose Our first aim is to facilitate the implementation of ESC cardio-oncology guidelines in clinical practice using an automated consultation tool. Our second aim is to use this tool as a platform to conduct the ML-CardioTox trial, designed to collect data from 600 patients followed in cardio-oncology outpatient clinics, treated with anthracyclines or anti-HER2 therapies, and managed in accordance with ESC recommendations. Baseline and follow-up data will be analysed using machine-learning approaches with the long-term objective of refining the HFA-ICOS risk score. Data collection is performed using a digital solution that enables automated cardiovascular risk stratification. The aim of this ancillary analysis is to evaluate the ability of the software to accurately stratify the risk of cardiotoxicity in individual patients. Methods The study started in October 2025 and is currently ongoing as a multicentre study. At the time of abstract submission, 23 patients had been enrolled. For each patient, baseline cardiotoxicity risk stratification was manually calculated using the HFA-ICOS score as implemented in the ESC Pocket Guidelines application or ESC guidelines and compared with the automated risk assessment generated by the software when proposing a surveillance strategy in accordance with these recommendations. Results Abstract Picure 1 summarises the clinical and paraclinical characteristics of the 20 patients relevant for HFA-ICOS score calculation and treated with anthracyclines. The figure also presents cardiotoxicity risk categories automatically generated by the digital solution (8 patients classified as low risk, 4 as moderate risk, and 8 as high risk). Manual calculation of baseline cardiotoxicity risk was strictly identical to the automated assessment, with a 100% concordance between the two approaches (Abstract Picture 2). Conclusion(s) In this preliminary cohort of patients, automated cardiotoxicity risk stratification performed by the software, based on the HFA-ICOS score, demonstrated reliable agreement with manual assessment. Beyond risk stratification, the automated consultation tool may serve as a platform for the creation of large cardio-oncology databases across Europe and contribute to reducing heterogeneity in the cardiovascular care of patients with cancer.HFA-ICOS scores of included patients Comparison of risk stratification
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