Prophylactic Agents for Preventing Cardiotoxicity Induced Following
Anticancer Agents: A Systematic Review and Meta-Analysis of Clinical
Trials

Ehsan      Keshavarzian; Tella      Sadighpour; Seyed   Mohammadreza   Mortazavizadeh; Mohammadhossein      Soltani; Amir   Farzin   Motevalipoor; Shahriyar   Shahbazi   Khamas; Mohammad      Moazen; Mohammad      Kogani; Seyed Mohammad      Amin Hashemipour; Hamid      Hosseinpour; Rohollah      Valizadeh

doi:10.2174/1574887118666230118102252

Abstract

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: In this meta-analysis, Scopus, Web of Science, and PubMed were surfed for articles published by December 30^th, 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.

Keywords: ACE inhibitor, anthracyclines, beta blocker, cancer, ejection fraction, prophylactic agents.

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DOI https://dx.doi.org/10.2174/1574887118666230118102252	Print ISSN 1574-8871
Publisher Name Bentham Science Publisher	Online ISSN 1876-1038

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Prophylactic Agents for Preventing Cardiotoxicity Induced Following Anticancer Agents: A Systematic Review and Meta-Analysis of Clinical Trials

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