心血管预防策略以癌症队列中的有效性未知的风险评分为指导。本研究旨在评估英国生物银行癌症幸存者中 7 个既定心血管风险评分的预测性能。QRISK3、系统性冠状动脉风险评估 2 (SCORE2) 的预测性能)/老年人系统性冠状动脉风险评估 (SCORE-OP)、Framingham 风险评分、预防心力衰竭的队列方程 (PCP-HF)、CHARGE-AF、QStroke 和 CHA2DS2-VASc 在有或没有心脏病的参与者中进行计算癌症史。参与者在年龄、性别、贫困、健康行为、家族史和代谢状况方面进行倾向匹配。分析按任何癌症、乳腺癌、肺癌、前列腺癌、脑/中枢神经系统、血液恶性肿瘤、霍奇金淋巴瘤和非霍奇金淋巴瘤进行分层。通过长达 10 年的跟踪健康记录链接来跟踪心血管事件的发生。报告了接受者操作曲线下面积、平衡准确性和敏感性。分析包括 31,534 名癌症幸存者和 126,136 名协变量匹配对照。病例和对照的风险评分分布几乎相同。患有任何癌症的参与者所有心血管结局的发生率均显着高于匹配的对照组。癌症病例中所有风险评分的绩效指标均明显低于匹配对照。最显着的差异是有血液恶性肿瘤病史的参与者，与匹配的对照相比，他们的结果率显着更高，但风险评分表现更差。患有脑/中枢神经系统癌症的参与者预测中风的风险评分表现非常差，预测准确性比非癌症对照低 30% 以上。与非癌症对照者相比，现有心血管风险评分在癌症幸存者中的预测准确性明显较差，导致该群体的风险被低估。© 2024 作者。

Cardiovascular preventive strategies are guided by risk scores with unknown validity in cancer cohorts.This study aimed to evaluate the predictive performance of 7 established cardiovascular risk scores in cancer survivors from the UK Biobank.The predictive performance of QRISK3, Systematic Coronary Risk Evaluation 2 (SCORE2)/Systematic Coronary Risk Evaluation for Older Persons (SCORE-OP), Framingham Risk Score, Pooled Cohort equations to Prevent Heart Failure (PCP-HF), CHARGE-AF, QStroke, and CHA2DS2-VASc was calculated in participants with and without a history of cancer. Participants were propensity matched on age, sex, deprivation, health behaviors, family history, and metabolic conditions. Analyses were stratified into any cancer, breast, lung, prostate, brain/central nervous system, hematologic malignancies, Hodgkin lymphoma, and non-Hodgkin lymphoma. Incident cardiovascular events were tracked through health record linkage over 10 years of follow-up. The area under the receiver operating curve, balanced accuracy, and sensitivity were reported.The analysis included 31,534 cancer survivors and 126,136 covariate-matched controls. Risk score distributions were near identical in cases and controls. Participants with any cancer had a significantly higher incidence of all cardiovascular outcomes than matched controls. Performance metrics were significantly worse for all risk scores in cancer cases than in matched controls. The most notable differences were among participants with a history of hematologic malignancies who had significantly higher outcome rates and poorer risk score performance than their matched controls. The performance of risk scores for predicting stroke in participants with brain/central nervous system cancer was very poor, with predictive accuracy more than 30% lower than noncancer controls.Existing cardiovascular risk scores have significantly worse predictive accuracy in cancer survivors compared with noncancer comparators, leading to an underestimation of risk in this cohort.© 2024 The Authors.