Efficacy of cardioprotective agents in reduction of chemotherapy related cardiotoxicity

Abstract

Background: We sought the efficacy of cardioprotective strategies in pts undergoing chemotherapy in a systemic review. Methods: A systemic review using (PubMed, Embase, screening reference sections) was undertaken using the following keywords cardiomyopathy, early detection and treatment, prevention, statins/beta blockers/ACE inhibitors in PubMed. Studies were included if pts undergoing chemotherapy were administered prophylactic treatment. We excluded pts with heart failure, multiple organ failure or disseminated cancer. Results: The initial search resulted in 1536 articles in the last 20 years. We excluded 1457 by topic review. We excluded 43 due to inability to match our inclusion criteria. After full text review, we selected 14 articles (n=3204, paediatric and adult) relating to anthracycline therapy. Amongst these, 3 were observational studies and the remainder, randomised controlled trials (RCT) (Table 1). The most common oncological condition was breast cancer. Dextrazoxane (DXO, RR 0.03-0.46), statins (RR 0.2), ACEi (RR 0.16-0.32) and beta blockade (RR 0.2) were effective in preventing LV dysfunction. (Table presented) Conclusions: Cardioprotection with DXO, ACE inhibitors, beta blockers and statins appear to have similar efficacy in prevention LV dysfunction.