The growing need for heart failure specific risk prediction models and standardized care pathways in patients with cancer

Cardiovascular disease remains the leading cause of morbidity and mortality among cancer survivors. Multiple cardiovascular risk prediction models exist to provide risk stratification for patients who are about to undergo cancer treatment. Current risk models have limited guidance on how to prevent, modify, and monitor for heart failure (HF) particularly heart failure with preserved ejection fraction (HFpEF). Cancer survivors are at an elevated risk for HFpEF due to the development of cardiometabolic syndrome associated with aging and long-term survival. Future efforts should focus on novel biomarkers in assessing HF, development of large, multicenter databases that can be used to validate models across diverse populations, and defining clear treatment pathways once risk is identified. A more comprehensive and inclusive risk stratification model with pragmatic approaches to clinical care will allow for more widespread use among cardiologists and oncologists.