HFA-ICOS Cardio-Oncology Risk Assessment for Anthracyclines
Heart Failure Association-International Cardio-Oncology Society risk stratification for cardiotoxicity prior to anthracycline-based chemotherapy. Classifies patients into low, moderate, high, or very high cardiac risk.
Score interpretation
HFA-ICOS Low Risk. <1% risk of major cardiac events during treatment.
→ Baseline echo. Repeat echo after treatment completion. Standard monitoring.
HFA-ICOS Moderate Risk. 1-5% risk of cardiotoxicity.
→ Baseline echo + troponin/BNP. Echo at treatment midpoint and completion. Cardioprotective agent (dexrazoxane) if high cumulative dose. Cardiology review recommended.
HFA-ICOS High Risk. >5% risk of cardiotoxicity.
→ Cardio-oncology assessment before starting treatment. Echo every 2 cycles + troponin monitoring. Cardioprotective strategies. Liposomal anthracycline if available.
Very high cardiac risk. Anthracycline therapy may cause irreversible cardiotoxicity.
→ Specialist cardio-oncology review mandatory. Consider alternative non-anthracycline regimen. If no alternative, maximum cardioprotection + intensive monitoring throughout.
Interpretation bands for the HFA-ICOS. Apply clinical judgement and local guidance.
References
- Lancellotti P, et al. Cardio-oncology services: rationale, organisation, and implementation: a HFA practical guidance document. Eur J Heart Fail. 2019;21(5):537-542.
- Lyon AR, et al. 2022 ESC Guidelines on cardio-oncology. Eur Heart J. 2022;43(41):4229-4361.
Related
Curated clinical cross-links plus same-class fallbacks.
- Idarubicin (Specialist drug) · Anthracycline chemotherapy
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Zoledronic Acid · Bisphosphonate (IV)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.