Key result
Dual ACEi/ARB and beta-blocker therapy is linked to higher heart failure rates during adjuvant trastuzumab.
Why the study?
Adjuvant trastuzumab therapy for early breast cancer with HER2 overexpression is potentially cardiotoxic, and the relationship between ACEi/ARBs and/or β-blockers use and heart failure or left ventricular dysfunction during therapy is unclear.
Does the use of ACEi/ARBs and/or β-blockers predict heart failure or LVEF recovery in women receiving adjuvant trastuzumab therapy for early breast cancer?
Population
499 women with early breast cancer and HER2 overexpression receiving adjuvant trastuzumab therapy
Comparison
Use of ACEi/ARBs and/or β-blockers versus no ACEi/ARBs or β-blockers
Design
Multicenter registry cohort study
Follow-up
1 year
Authors
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Identifies dual ACEi/ARB-β-blocker use as marker of higher HF risk during trastuzumab; leaves open whether therapy improves LVEF recovery.
Cohort (n=499)
Yes
Does the use of ACEi/ARBs and/or β-blockers predict heart failure or LVEF recovery in women receiving adjuvant trastuzumab therapy for early breast cancer?
Absolute Event Rate: 19% vs 2%
p-value: p=<0.01
In women receiving adjuvant trastuzumab for early breast cancer, the use of ACEi/ARBs and β-blockers marks higher baseline cardiovascular risk, but their combined use is associated with LVEF recovery between 3 and 12 months.
Oliva et al. (2012) conducted a cohort in Early breast cancer (n=499). ACEi/ARBs and/or β-blockers vs. No ACEi/ARBs or β-blockers was evaluated on Occurrence of heart failure (p=<0.01). During 1 year of adjuvant trastuzumab therapy, heart failure occurred in 19% of patients receiving both ACEi/ARBs and β-blockers, 8% receiving either alone, and 2% receiving neither.
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