{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:00:07Z","timestamp":1793775607215,"version":"4.6.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"48","license":[{"start":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T00:00:00Z","timestamp":1563408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Heart and Stroke Foundation of Canada","id":[{"id":"https:\/\/ror.org\/00qbpyp73","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canadian Institutes of Health Research New Investigator","id":[{"id":"https:\/\/ror.org\/01gavpb45","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tier 1 Canada Research Chair in Health Services Research"},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"MOHLTC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canadian Institute for Health Information","id":[{"id":"https:\/\/ror.org\/0112eam10","id-type":"ROR","asserted-by":"crossref"}]},{"name":"CIHI","id":[{"id":"https:\/\/ror.org\/0112eam10","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009142","name":"Cancer Care Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009142","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009142","name":"CCO","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009142","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Develop a score to predict the risk of major adverse cardiovascular events (MACE) after early stage breast cancer (EBC) to facilitate personalized decision-making about potentially cardiotoxic treatments and interventions to reduce cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Using administrative databases, we assembled a cohort of women diagnosed with EBC in Ontario between 2003 and 2014, with follow-up through 2015. Two-thirds of the cohort were used for risk score derivation; the remainder were reserved for its validation. The outcome was a composite of hospitalizations for acute myocardial infarction, unstable angina, transient ischaemic attack, stroke, peripheral vascular disease, heart failure (HF), or cardiovascular death. We developed the score by regressing MACE incidence against candidate predictors in the derivation sample using a Fine\u2013Gray model. Discrimination was assessed in the validation sample using Wolber\u2019s c-index for prognostic models with competing risks, while calibration was assessed by comparing predicted and observed MACE incidence. The risk score was derived in 60\u00a0294 women and validated in 29\u00a0810 women. Age, hypertension, diabetes, ischaemic heart disease, atrial fibrillation, HF, cerebrovascular disease, peripheral vascular disease, chronic obstructive pulmonary disease, and chronic kidney disease were significantly associated with MACE incidence and incorporated into the score. Ten-year MACE incidence was &amp;gt;40-fold higher for patients in the highest score decile compared to the lowest. The c-index was 81.9% (95% confidence interval 80.9\u201382.9%) at 5\u2009years and 79.8% (78.8\u201380.8%) at 10\u2009years in the validation cohort, with good agreement between predicted and observed MACE incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cardiovascular prognosis after EBC can be estimated using patients\u2019 pre-treatment characteristics.<\/jats:p>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehz460","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T15:12:46Z","timestamp":1560352366000},"page":"3913-3920","source":"Crossref","is-referenced-by-count":96,"title":["Development and validation of a multivariable prediction model for major adverse cardiovascular events after early stage breast cancer: a population-based cohort study"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-7931","authenticated-orcid":false,"given":"Husam","family":"Abdel-Qadir","sequence":"first","affiliation":[{"name":"Department of Medicine, Women's College Hospital Toronto , 76 Grenville St, Room 3444, Toronto, ON M5S 1B2, Canada"},{"name":"Department of Medicine, Division of Cardiology, Peter Munk Cardiac Centre, University Health Network , Toronto, ON, Canada"},{"name":"Cardiovascular Research Program, ICES , Toronto, ON, Canada"},{"name":"University of Toronto, Institute of Health Policy, Management, and Evaluation , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paaladinesh","family":"Thavendiranathan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Peter Munk Cardiac Centre, University Health Network , Toronto, ON, Canada"},{"name":"Joint Department of Medical Imaging, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C","family":"Austin","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Program, ICES , Toronto, ON, Canada"},{"name":"University of Toronto, Institute of Health Policy, Management, and Evaluation , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Peter Munk Cardiac Centre, University Health Network , Toronto, ON, Canada"},{"name":"Cardiovascular Research Program, ICES , Toronto, ON, Canada"},{"name":"University of Toronto, Institute of Health Policy, Management, and Evaluation , Toronto, ON, Canada"},{"name":"Joint Department of Medical Imaging, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3706-525X","authenticated-orcid":false,"given":"Eitan","family":"Amir","sequence":"additional","affiliation":[{"name":"University of Toronto, Institute of Health Policy, Management, and Evaluation , Toronto, ON, Canada"},{"name":"Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack V","family":"Tu","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Program, ICES , Toronto, ON, Canada"},{"name":"University of Toronto, Institute of Health Policy, Management, and Evaluation , Toronto, ON, Canada"},{"name":"Department of Medicine, Sunnybrook Health Sciences Centre , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinwah","family":"Fung","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Program, ICES , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey M","family":"Anderson","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Program, ICES , Toronto, ON, Canada"},{"name":"University of Toronto, Institute of Health Policy, Management, and Evaluation , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,18]]},"reference":[{"key":"2022102609350342400_ehz460-B1","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1093\/eurheartj\/ehw211","article-title":"2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: the Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC)","volume":"37","author":"Zamorano","year":"2016","journal-title":"Eur Heart 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