Key result
Cardiac CARE trial evaluates troponin-guided candesartan and carvedilol to prevent LV dysfunction following anthracycline therapy.
Why the study?
Anthracyclines cause cardiotoxicity and heart failure with variable severity and no proven therapeutic intervention, while neurohormonal blockade has shown modest cardioprotective effects in unselected patients.
Does troponin-guided treatment with combination candesartan and carvedilol prevent the development of left ventricular dysfunction in high-risk patients receiving anthracycline chemotherapy?
Population
Patients with breast cancer and non-Hodgkin lymphoma receiving anthracycline chemotherapy with high-sensitivity cTnI in the upper tertile
Comparison
Standard of care plus candesartan and carvedilol vs standard of care alone
Design
Multicentre prospective randomized open-label blinded end point trial
Follow-up
6 months after chemotherapy
Authors
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May support selective cardioprotection with beta blockers or RAS inhibitors in anthracycline recipients; leaves open whether RCTs will confirm benefit.
RCT
Open-label, blinded endpoint (PROBE)
1:1
Yes
Does troponin-guided treatment with combination candesartan and carvedilol prevent the development of left ventricular dysfunction in high-risk patients receiving anthracycline chemotherapy?
The Cardiac CARE trial is designed to evaluate whether troponin-guided neurohormonal blockade with candesartan and carvedilol can prevent left ventricular dysfunction in high-risk patients receiving anthracycline chemotherapy.
Henriksen et al. (2022) conducted an RCT in Breast cancer and non-Hodgkin lymphoma receiving anthracycline chemotherapy. Candesartan and carvedilol vs. Standard of care alone was evaluated on Change in left ventricular ejection fraction at 6 months after chemotherapy. The Cardiac CARE trial is a rationale and design study evaluating whether troponin-guided treatment with candesartan and carvedilol prevents left ventricular dysfunction following anthracycline therapy.
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