Beta-blockers for the primary prevention of anthracycline-induced cardiotoxicity: a meta-analysis of randomized controlled trials.
BMC Pharmacol Toxicol
; 20(1): 18, 2019 04 25.
Article
em En
| MEDLINE
| ID: mdl-31023386
ABSTRACT
BACKGROUND:
The effects of ß blockers on the primary prevention of anthracycline-induced cardiotoxicity were controversial.METHODS:
We searched PubMed, Embase and Cochrane Library for randomized controlled trials of the comparison of ß blockers versus placebo in patients undergoing anthracycline chemotherapy. This meta-analysis was performed by using random-effect models.RESULTS:
Nine hundred forty participants from 11 trials were included in this meta-analysis. ß blockers led to a significant reduction in symptomatic heart failure (risk ratio [RR] 0.29, 95% CI 0.10 to 0.85). Compared with placebo, ß blockers were associated with improved left ventricular ejection fraction (mean difference [MD] 4.46, 95% CI 1.77 to 7.15) and s' (MD 0.78, 95% CI 0.01 to 1.55) in parallel with reduced left ventricular diameter (left ventricular end systolic diameter, MD -3.19, 95% CI -6.17 to - 0.21; left ventricular end diastolic diameter, MD -2.28, 95% CI 4.50 to - 0.05). ß blockers also improved strain and strain rate when compared with placebo. There were no significant differences in diastolic function variables between ß blockers and placebo except e' (MD 2.33, 95% CI 0.16 to 4.51). In addition, ß blockers compared with placebo reduced the risk of cardiac troponin I elevation > 0.04 ng/ml (RR 0.60, 95% CI 0.42 to 0.85). There was no marked difference in adverse events (RR 0.94, 95% CI 0.56 to 1.59) between ß blockers and placebo.CONCLUSIONS:
In cancer patients with anthracycline therapy, prophylactic ß blockers were associated with reduced risk of heart failure, decreased left ventricular diameter, improved left ventricular systolic function, and alleviative cardiomyocyte injury.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Antagonistas Adrenérgicos beta
/
Antraciclinas
/
Cardiotoxicidade
/
Antibióticos Antineoplásicos
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
BMC Pharmacol Toxicol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
China