P6255Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin

Aims: Deterioration in ventricular function is often observed in patients treated with anthracyclines for cancer. There is a paucity of evidence on interventions that might provide cardio-protection. We investigated whether carvedilol can prevent doxorubicin-induced cardiotoxicity and whether any observed effect is dose related. Methods and results: A prospective, randomized, double-blind study in patients treated with doxorubicin, comparing placebo (n=38) with different doses of carvedilol [6.25 mg/day (n=41), 12.5 mg/day (n=38) or 25 mg/day (n=37)]. The primary endpoint was the measured change in left ventricular ejection fraction (LVEF) from baseline to 6 months. LVEF decreased from 62%±5% at baseline to 58%±7% at 6-months (p=0.002) in patients assigned to placebo but no statistically significant changes were observed in any of the 3 carvedilol groups. At 6 months, only one of 116 patients (1%) assigned to carvedilol had an LVEF <50% compared to four of the 38 assigned to placebo (11%), (p=0.013). No significant differences were noted between carvedilol and placebo in terms of the development of diastolic dysfunction, clinically overt heart failure or death.