Anti-cancer treatment can be fraught with cardiovascular complications, which is the most common cause of death among oncological survivors. Without appropriate cardiomonitoring during anti-cancer treatment, it becomes challenging to detect early signs of cardiovascular complications. In order to achieve higher survival rates, it is necessary to monitor oncological patients outpatiently after anti-cancer treatment administration. In this regard, we aim to evaluate the efficacy of single-lead ECG remote monitoring to detect cardiotoxicity in cancer patients with minimal cardiovascular diseases after the first cycle of polychemotherapy. The study included patients 162 patients over 18 years old with first diagnosed different types of solid tumors, planed for adjuvant (within 8 weeks after surgery) or neoadjuvant polychemotherapy. All patients were monitored, outpatiently, during 14–21 days (depending on the regimen of polychemotherapy) after polychemotherapy administration using single-lead ECG. QTc > 500 mc prolongation was detected in 8 patients (6.6 %), first-diagnosed arial fibrillation was detected in 11 patients (9 %) in period after chemotherapy administration. Moreover, left ventricular diastolic dysfunction using single-lead ECG after polychemotherapy was detected in 49 (40.1 %) patients with sensitivity 80 %, specificity 95 %, AUC 0.88 (95 % CI, 0.82–0.93). The side effects of cancer treatment may cause life-threatening risks. Early identification of cardiotoxicity plays a vital role in the solution of this problem. Using portable devices to detect early cardiotoxicity is a simple, convenient and affordable screening method, that can be used for promptly observation of patients.
Background/Objectives: To evaluate the Risk Factor-Weighted Clinical Likelihood (RF-CL) model for the diagnosis of chronic coronary syndrome (CCS) in men and women. Methods: The study included 222 patients (100 men and 122 women; mean age 64.76 ± 10.3 years) with suspected CCS. Diagnostic evaluation was performed in accordance with the 2024 clinical practice guidelines for stable coronary artery disease developed by the Russian Society of Cardiology. The clinical probability of obstructive coronary artery disease (CAD) was calculated for all patients using the RF-CL model. Results: Application of the RF-CL model demonstrated higher probabilities in men than in women (17% [11–27] vs. 6% [4,5,6,7,8,9,10], p < 0.001). Moderate CCS probability (RF-CL > 15–50%) was observed in 64% of men and 9.8% of women (p < 0.001); low probability (RF-CL > 5–15%) in 30% and 60.7% (p < 0.001); very low (RF-CL ≤ 5%) in 6% and 29.5% (p < 0.001). The prevalence of typical angina (21% vs. 17.2%, p = 0.47), atypical angina (31% vs. 26.2%, p = 0.43), and non-anginal chest pain (31% vs. 26.2%, p = 0.43) did not differ. Dyspnea was less frequent in men (44% vs. 59.8%, p = 0.02). Only 35 (15.8%) patients had indications for invasive coronary angiography (ICA), and significant stenosis (≥70%) was found in 17 patients. According to the ROC analysis, the cutoff value of RF-CL for predicting a positive stress test was 19.5% in men (AUC 0.723; p = 0.002), 6.5% in women (AUC 0.479; p = 0.852), and 15% in the overall cohort (AUC 0.737; p < 0.0001). Conclusions: Men with moderate and women with low probability of obstructive CAD are predominantly encountered in clinical practice when the RF-CL model is applied. Our observations have shown that ICA is indicated in relatively few patients and suggest potential overuse of exercise testing regardless of the clinicians’ adherence to the traditional Diamond–Forrester model or the RF-CL algorithm in suspected CCS.