| Initial workup |
| Comprehensive patient history |
| Blood pressure measurement |
| Electrocardiogram |
| Concomitant medications |
| CV risk factor assessment: the presence of diabetes, obesity, hypertension, dyslipidemia, chronic renal disease |
| History of valvular heart disease |
| History of arrhythmias, heart failure, or left ventricular dysfunction/reduced ejection fraction |
| History of ischemic heart disease |
| For patients with high CV risk or established CV disease |
| Echocardiogram |
| Baseline cardiac biomarkers |
| Consider using FRS-CVD65 score for stratification |
| Treatment selection |
| Patients with no CV risk factors |
| Any approved BTKi |
| If other safety concerns, favor more selective drugs (acalabrutinib or zanubrutinib) or Bcl-2 inhibitors |
| Patients with CV risk (eg, well-controlled AF, HTN) |
| Consider second-generation BTKis (acalabrutinib or zanubrutinib) |
| Initial workup |
| Comprehensive patient history |
| Blood pressure measurement |
| Electrocardiogram |
| Concomitant medications |
| CV risk factor assessment: the presence of diabetes, obesity, hypertension, dyslipidemia, chronic renal disease |
| History of valvular heart disease |
| History of arrhythmias, heart failure, or left ventricular dysfunction/reduced ejection fraction |
| History of ischemic heart disease |
| For patients with high CV risk or established CV disease |
| Echocardiogram |
| Baseline cardiac biomarkers |
| Consider using FRS-CVD65 score for stratification |
| Treatment selection |
| Patients with no CV risk factors |
| Any approved BTKi |
| If other safety concerns, favor more selective drugs (acalabrutinib or zanubrutinib) or Bcl-2 inhibitors |
| Patients with CV risk (eg, well-controlled AF, HTN) |
| Consider second-generation BTKis (acalabrutinib or zanubrutinib) |
FRS-CVD, Framingham risk score-cardiovascular disease.