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Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin
OBJECTIVE: 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 prophylactic use of carvedilol can prevent doxorubicin-induced cardioto...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310701/ https://www.ncbi.nlm.nih.gov/pubmed/30595329 http://dx.doi.org/10.1016/j.ihj.2018.06.011 |
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author | Abuosa, Ahmed Mohamed Elshiekh, Ayman Hassan Qureshi, Kahekashan Abrar, Mohammed Burhan Kholeif, Mona A. Kinsara, Abdulhalim Jamal Andejani, Abdulwahab Ahmed, Adel H. Cleland, John G.F. |
author_facet | Abuosa, Ahmed Mohamed Elshiekh, Ayman Hassan Qureshi, Kahekashan Abrar, Mohammed Burhan Kholeif, Mona A. Kinsara, Abdulhalim Jamal Andejani, Abdulwahab Ahmed, Adel H. Cleland, John G.F. |
author_sort | Abuosa, Ahmed Mohamed |
collection | PubMed |
description | OBJECTIVE: 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 prophylactic use of carvedilol can prevent doxorubicin-induced cardiotoxicity and whether any observed effect is dose related. METHODS: 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. RESULTS: 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. CONCLUSIONS: Carvedilol might prevent deterioration in LVEF in cancer patients treated with doxorubicin. This effect may not be dose related within the studied range. |
format | Online Article Text |
id | pubmed-6310701 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-63107012019-12-01 Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin Abuosa, Ahmed Mohamed Elshiekh, Ayman Hassan Qureshi, Kahekashan Abrar, Mohammed Burhan Kholeif, Mona A. Kinsara, Abdulhalim Jamal Andejani, Abdulwahab Ahmed, Adel H. Cleland, John G.F. Indian Heart J Clinical and Preventive Cardiology OBJECTIVE: 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 prophylactic use of carvedilol can prevent doxorubicin-induced cardiotoxicity and whether any observed effect is dose related. METHODS: 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. RESULTS: 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. CONCLUSIONS: Carvedilol might prevent deterioration in LVEF in cancer patients treated with doxorubicin. This effect may not be dose related within the studied range. Elsevier 2018-12 2018-06-18 /pmc/articles/PMC6310701/ /pubmed/30595329 http://dx.doi.org/10.1016/j.ihj.2018.06.011 Text en © 2018 Published by Elsevier B.V. on behalf of Cardiological Society of India. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical and Preventive Cardiology Abuosa, Ahmed Mohamed Elshiekh, Ayman Hassan Qureshi, Kahekashan Abrar, Mohammed Burhan Kholeif, Mona A. Kinsara, Abdulhalim Jamal Andejani, Abdulwahab Ahmed, Adel H. Cleland, John G.F. Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
title | Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
title_full | Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
title_fullStr | Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
title_full_unstemmed | Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
title_short | Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
title_sort | prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin |
topic | Clinical and Preventive Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310701/ https://www.ncbi.nlm.nih.gov/pubmed/30595329 http://dx.doi.org/10.1016/j.ihj.2018.06.011 |
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