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

Abuosa, A. M., Elshiekh, A. H., Qureshi, K., Abrar, M. B., Kholeif, M. A., Kinsara, A. J., Andejani, A., Ahmed, A. H. and Cleland, J. G.F. (2018) Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin. Indian Heart Journal, 70(S3), S96-S100. (doi: 10.1016/j.ihj.2018.06.011) (PMID:30595329)

Abstract

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Abuosa, A. M., Elshiekh, A. H., Qureshi, K., Abrar, M. B., Kholeif, M. A., Kinsara, A. J., Andejani, A., Ahmed, A. H., and Cleland, J. G.F.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Indian Heart Journal
• Publisher: Elsevier
• ISSN: 0019-4832
• ISSN (Online): 0019-4832
• Published Online: 18 June 2018
• Copyright Holders: Copyright © 2018 Cardiological Society of India
• First Published: First published in Indian Heart Journal 70(S3): S96-S100
• Publisher Policy: Reproduced under a Creative Commons License