What is the clinical evidence from this study?

Study design: RCT. Population: adriamycin-induced cardiomyopathy (n=54). Intervention: carvedilol vs. control. Primary outcome: left ventricular ejection fraction (null, 95% CI null, p=0.003).

November 1, 2016The Indian Journal of Medical ResearchOpen Access

Preventive role of carvedilol in adriamycin-induced cardiomyopathy

Q: What does this research mean for the field?

Carvedilol maintains left ventricular ejection fraction at 63.88%, while control significantly decreased to 60.82% (P=0.003) in patients receiving adriamycin chemotherapy. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

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Key result

Carvedilol prevents a ~3% drop in LVEF versus control during adriamycin chemotherapy.

null
95% CI null
P=0.003
n=54

Why the study?

Does prophylactic carvedilol prevent adriamycin-induced left ventricular systolic dysfunction in patients with haematological malignancies?

Population

54 newly diagnosed patients with haematological malignancy planned for adriamycin chemotherapy, mean age…

Comparison

Carvedilol 12.5 mg oral once daily, started… vs Control group receiving standard chemotherapy…

Design

RCT, Randomly divided into two groups on the basis of a random table., One…

Follow-up

6 months

Authors

RJRajesh JhorawatSawai ManSingh Medical College and Hospital SKSavita KumariMaharishi Markandeshwar University, Mullana SVSubhash VarmaPost Graduate Institute of Medical Education and Research

Discussion

Member takes

Implication

Carvedilol prophylaxis preserves LVEF during adriamycin chemotherapy; reinforces limited RCT evidence for anthracycline cardioprotection.

Study Design

Type

RCT (n=54)

Blinding

null

Randomization

null

Multicenter

Structured PICO

Does prophylactic carvedilol prevent adriamycin-induced left ventricular systolic dysfunction in patients with haematological malignancies?

Population

54 newly diagnosed patients with haematological malignancy (lymphoreticular malignancy) planned for adriamycin (ADR) chemotherapy, mean age 43.89 (carvedilol) and 38.74 (control), predominantly male. Key exclusions: prior chemotherapy or thoracic radiotherapy, coronary arterial disease, established dilated or restrictive cardiomyopathy, moderate-to-severe valvular dysfunction, pericardial effusion, diabetes mellitus, renal dysfunction, and thyroid disorder.

Intervention

Carvedilol 12.5 mg oral once daily, started before chemotherapy and maintained for 6 months during chemotherapy.

Comparator

Control group receiving standard chemotherapy without carvedilol or placebo.

Outcome

Systolic functions (left ventricular ejection fraction) and death at 6 months follow-up.surrogate

Main Result

Effect estimate: null (95% CI null)

Absolute Event Rate: 63.88% vs 60.82%

p-value: p=0.003

Prophylactic use of low-dose carvedilol preserves left ventricular systolic function in patients receiving anthracycline chemotherapy.

Limitations

Limited sample size
Not placebo controlled
Different baseline ejection fractions between groups
Limited number of patients
Low adriamycin dose used
Echocardiography is operator dependent
Did not use advanced imaging such as strain/3D echo or tissue Doppler

Cite This Study

Jhorawat et al. (2016) conducted an RCT in adriamycin-induced cardiomyopathy (n=54). carvedilol vs. control was evaluated on left ventricular ejection fraction (null, 95% CI null, p=0.003). Carvedilol maintained left ventricular ejection fraction at 63.88%, while control significantly decreased to 60.82% (P=0.003) in patients receiving adriamycin chemotherapy.

synapsesocial.com/papers/696d7362fa2b4be5f0d9668a https://doi.org/10.4103/ijmr.ijmr_1323_14

Topics

HFrEF treatment Echocardiography Cardiomyopathy Heart failure

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November 1, 2016The Indian Journal of Medical ResearchOpen Access

Preventive role of carvedilol in adriamycin-induced cardiomyopathy

View Full Paper

Ask AI

Bookmark

Key result

Carvedilol prevents a ~3% drop in LVEF versus control during adriamycin chemotherapy.

null
95% CI null
P=0.003
n=54

Why the study?

Does prophylactic carvedilol prevent adriamycin-induced left ventricular systolic dysfunction in patients with haematological malignancies?

Population

54 newly diagnosed patients with haematological malignancy planned for adriamycin chemotherapy, mean age…

Comparison

Carvedilol 12.5 mg oral once daily, started… vs Control group receiving standard chemotherapy…

Design

RCT, Randomly divided into two groups on the basis of a random table., One…

Follow-up

6 months

Authors

RJRajesh JhorawatSawai ManSingh Medical College and Hospital SKSavita KumariMaharishi Markandeshwar University, Mullana SVSubhash VarmaPost Graduate Institute of Medical Education and Research

Discussion

Member takes

Implication

Carvedilol prophylaxis preserves LVEF during adriamycin chemotherapy; reinforces limited RCT evidence for anthracycline cardioprotection.

Study Design

Type

RCT (n=54)

Blinding

null

Randomization

null

Multicenter

Structured PICO

Does prophylactic carvedilol prevent adriamycin-induced left ventricular systolic dysfunction in patients with haematological malignancies?

Population

Intervention

Carvedilol 12.5 mg oral once daily, started before chemotherapy and maintained for 6 months during chemotherapy.

Comparator

Control group receiving standard chemotherapy without carvedilol or placebo.

Outcome

Systolic functions (left ventricular ejection fraction) and death at 6 months follow-up.surrogate

Main Result

Effect estimate: null (95% CI null)

Absolute Event Rate: 63.88% vs 60.82%

p-value: p=0.003

Prophylactic use of low-dose carvedilol preserves left ventricular systolic function in patients receiving anthracycline chemotherapy.

Limitations

Limited sample size
Not placebo controlled
Different baseline ejection fractions between groups
Limited number of patients
Low adriamycin dose used
Echocardiography is operator dependent
Did not use advanced imaging such as strain/3D echo or tissue Doppler

Cite This Study

synapsesocial.com/papers/696d7362fa2b4be5f0d9668a https://doi.org/10.4103/ijmr.ijmr_1323_14

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

HFrEF treatment Echocardiography Cardiomyopathy Heart failure

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