Anthracycline-associated cardiotoxicity in adults: systematic review on the cardioprotective role of beta-blockers

Author:

Barbosa Roberto Ramos1ORCID,Bourguignon Taissa Borges1,Torres Luíza Dias1,Arruda Lorenza Silveira1,Jacques Tiago de Melo1,Serpa Renato Giestas1,Calil Osmar de Araujo1,Barbosa Luiz Fernando Machado1

Affiliation:

1. School of Sciences of Santa Casa de Misericórdia de Vitoria, Brasil

Abstract

SUMMARY OBJECTIVES This study aimed at assessing the role of beta-blockers on preventing anthracycline-induced cardiotoxicity in adults. METHODS A systematic review was performed on electronic databases, including relevant studies that analysed beta-blockers as cardioprotective agents before the use of anthracyclines by adult oncologic patients. RESULTS After application of eligibility and selection criteria, eight articles were considered as high quality, complying with the proposed theme; all eight clinical trials, four of them placebo-controlled, with a total number of 655 patients included. From this sample, 281 (42.9%) used beta-blocker as intervention, and carvedilol was the most frequent (167 patients – 25.5%). Six studies were considered positive regarding the cardioprotection role played by beta-blockers, although only four demonstrated significant difference on left ventricle ejection fraction after chemotherapy on groups that used beta-blockers compared to control groups. Carvedilol and nebivolol, but not metoprolol, had positive results regarding cardioprotection. Other beta-blockers were not analysed in the selected studies. CONCLUSIONS Despite the potential cardioprotective effect of beta-blockers, as demonstrated in small and unicentric clinical trials, its routine use on prevention of anthracycline-associated cardiotoxicity demands greater scientific evidence.

Publisher

FapUNIFESP (SciELO)

Subject

General Medicine

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