Anthracycline-associated cardiotoxicity in adults: systematic review on the cardioprotective role of beta-blockers
Roberto Ramos Barbosa, Taissa Borges Bourguignon, Luíza Dias Torres, Lorenza Silveira Arruda, Tiago de Melo Jacques, Renato Giestas Serpa, Osmar de Araujo Calil, Luiz Fernando Machado Barbosa, Roberto Ramos Barbosa, Taissa Borges Bourguignon, Luíza Dias Torres, Lorenza Silveira Arruda, Tiago de Melo Jacques, Renato Giestas Serpa, Osmar de Araujo Calil, Luiz Fernando Machado Barbosa
Abstract
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.
Source: PubMed