Prophylactic treatment with cardio-protective drugs prevented ejection fraction drop at 6 months in patients receiving anthracyclines compared to control (SMD 0.40; 95% CI 0.27-0.54).
Meta-Analysis (n=2,674)
Do prophylactic cardio-protective drugs prevent ejection fraction drop in patients undergoing chemotherapy with anthracyclines?
Prophylactic treatment with cardio-protective drugs such as dexrazoxane, beta-blockers, and ACE inhibitors helps preserve left ventricular ejection fraction in patients receiving anthracycline chemotherapy.
Standardized Mean Difference: 0.4 (95% CI 0.27–0.54)
Absolute Event Rate: 59.63% vs 57.69%
BACKGROUND: Anthracyclines can improve survival in many types of malignancies, but dose-dependent and irreversible results following the use of anthracyclines have been associated with cardiomyopathy. This meta-analysis aimed to compare the effects of prophylactic agents for preventing cardiotoxicity induced following anticancer agents. METHODS: , 2020. The keywords were angiotensin-converting enzyme inhibitor (ACEI), enalapril, captopril, angiotensin receptor blocker, beta blocker, metoprolol, bisoprolol, isoprolol, statin, valsartan, losartan, eplerenone, idarubicin, nebivolol, dihydromyricetin, ampelopsin, spironolactone, dexrazoxane, antioxidants, cardiotoxicity, n-acetyl-tryptamine, cancer, neoplasms, chemotherapy, anthracyclines, doxorubicin, daunorubicin, epirubicin, idarubicin, ejection fraction or a combination of them in the titles or abstracts. RESULTS: A total of 17 articles out of 728 studies examining 2,674 patients were included in this systematic review and meta-analysis. Ejection fraction (EF) values in the baseline, 6-month, and 12-month follow-up in the intervention group turned out to be 62.52 ± 2.48, 59.63 ± 4.85, and 59.42 ± 4.53, whereas in the control group appeared to be 62.81 ± 2.58, 57.69 ± 4.32, and 58.60 ± 4.58, respectively. Through comparison of the two groups, EF was found to increase in the intervention group by 0.40 after 6 months (Standardized mean difference (SMD): 0.40, 95% confidence interval (CI): 0.27, 0.54), thus proving higher than that of the control groups following the cardiac drugs. CONCLUSION: This meta-analysis showed that prophylactic treatment with cardio-protective drugs, including dexrazoxane, beta blocker, and ACEI drugs in patients undergoing chemotherapy with anthracycline, have a protective effect on LVEF and prevent EF drop.
Hashemipour et al. (Wed,) conducted a meta-analysis in Cardiotoxicity induced by anthracyclines (n=2,674). Prophylactic cardio-protective drugs (dexrazoxane, beta blockers, ACEIs) vs. Control was evaluated on Ejection fraction at 6 months (SMD 0.40, 95% CI 0.27-0.54). Prophylactic treatment with cardio-protective drugs prevented ejection fraction drop at 6 months in patients receiving anthracyclines compared to control (SMD 0.40; 95% CI 0.27-0.54).