Candesartan and carvedilol for primary prevention of subclinical cardiotoxicity in breast cancer patients without a cardiovascular risk treated with doxorubicin.
Cancer Med
; 10(12): 3964-3973, 2021 06.
Article
en En
| MEDLINE
| ID: mdl-33998163
ABSTRACT
BACKGROUND:
There is no proven primary preventive strategy for doxorubicin-induced subclinical cardiotoxicity (DISC), especially among patients without a cardiovascular (CV) risk. We investigated the primary preventive effect on DISC of the concomitant use of angiotensin receptor blockers (ARBs) or beta-blockers (BBs), especially among breast cancer patients without a CV risk.METHODS:
A total of 385 patients who were scheduled for doxorubicin chemotherapy were screened. Among them, 195 patients of the study populations were included and were randomly divided into two groups [candesartan 4 mg q.d. vs. carvedilol 3.125 mg q.d.] and patients who were unwilling to take one of the medications were evaluated as controls. The primary outcomes were the incidence of early DISC (DISC developing within 6 months after chemotherapy), and late DISC (DISC developing only at least 12 months after chemotherapy).RESULT:
Compared with the control group (8 out of 43 patients (18.6%)), only the candesartan group (4 out of 82 patients (4.9%)) showed a significantly lower incidence of early DISC (p = 0.022). Compared with the control group, the candesartan group demonstrated a significantly reduced decrease in left ventricular ejection fraction (LVEF) throughout the study period [-1.0% vs. -3.00 (p < 0.001) at the first follow-up, -1.10% vs. -3.40(p = 0.009) at the second follow-up].CONCLUSIONS:
Among breast cancer patients without a CV risk treated with doxorubicin-containing chemotherapy, subclinical cardiotoxicity is prevalent and concomitant administration of low-dose candesartan might be effective to prevent an early decrease in LVEF. Further large-scale, randomized controlled trials will be needed to confirm our findings.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Tetrazoles
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Bencimidazoles
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Compuestos de Bifenilo
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Neoplasias de la Mama
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Doxorrubicina
/
Cardiotoxicidad
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Carvedilol
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Antibióticos Antineoplásicos
/
Antihipertensivos
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Middle aged
Idioma:
En
Revista:
Cancer Med
Año:
2021
Tipo del documento:
Article