Beta-blockers for the primary prevention of anthracycline-induced cardiotoxicity: a meta-analysis of randomized controlled trials.

ABSTRACT: BACKGROUND:The effects of ? blockers on the primary prevention of anthracycline-induced cardiotoxicity were controversial. METHODS:We searched PubMed, Embase and Cochrane Library for randomized controlled trials of the comparison of ? blockers versus placebo in patients undergoing anthracycline chemotherapy. This meta-analysis was performed by using random-effect models. RESULTS:Nine hundred forty participants from 11 trials were included in this meta-analysis. ? blockers led to a significant reduction in symptomatic heart failure (risk ratio [RR] 0.29, 95% CI 0.10 to 0.85). Compared with placebo, ? blockers were associated with improved left ventricular ejection fraction (mean difference [MD] 4.46, 95% CI 1.77 to 7.15) and s' (MD 0.78, 95% CI 0.01 to 1.55) in parallel with reduced left ventricular diameter (left ventricular end systolic diameter, MD -3.19, 95% CI -6.17 to -?0.21; left ventricular end diastolic diameter, MD -2.28, 95% CI 4.50 to -?0.05). ? blockers also improved strain and strain rate when compared with placebo. There were no significant differences in diastolic function variables between ? blockers and placebo except e' (MD 2.33, 95% CI 0.16 to 4.51). In addition, ? blockers compared with placebo reduced the risk of cardiac troponin I elevation >?0.04?ng/ml (RR 0.60, 95% CI 0.42 to 0.85). There was no marked difference in adverse events (RR 0.94, 95% CI 0.56 to 1.59) between ? blockers and placebo. CONCLUSIONS:In cancer patients with anthracycline therapy, prophylactic ? blockers were associated with reduced risk of heart failure, decreased left ventricular diameter, improved left ventricular systolic function, and alleviative cardiomyocyte injury.

SUBMITTER: Ma Y 

PROVIDER: S-EPMC6485127 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature