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Temat i słowa kluczowe:
cardiotoxicity ; ACEI ; prevention ; breast cancer ; anthracyclines
Abstrakt:
Introduction: Anthracyclines may induce irreversible cardiomiopathy in oncological patients. Cardiotoxicity (AIC) may negatively influence the life expectancy. Thus AIC prevention remains the main priority.Purpose: Assessment of the cardioprotective properties of one-year Ramipril therapy in early breast cancer patients without significant cardiovascular diseases, treated with low cumulative anthracycline doses.Methods: We conducted a prospective randomized (1:1) non-placebo controlled trial. One of the two groups received ramipril for 48 weeks. Women were monitored by means of echocardiography and laboratory parameters. Cardiotoxicity was defined as a decrease in LVEF or as an increase of biomarkers. Percentage of patients with AIC was compared among arms . Quantitative analysis of NT-proBNP and LVEF was also conducted. Heart failure occurrence or cases of cardiac death were monitored.Results: Percentage of patients with AIC did not significantly vary between the groups. LVEF decline below 50% was not recorded in any of the groups. NT-proBNP value increased in the control group whereas it remained stable in Ramipril arm. Percentage of patients with AIC (analyzed in every moment of measurement) increased with time which was not the case in intervention group.Conclusions: No preventive effect of Ramipril could have been proven. However, AIC incidence, in analyzed population and ; one year observation, was relatively low. Ramipril influenced positively cardiotoxicity at a biochemical level. Clinical utility of this finding warrants further investigation.
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Dyscyplina:
onkologia ; choroby układu krążenia