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
{"title":"预防抗癌药物引起的心脏毒性:临床试验的系统回顾和荟萃分析。","authors":"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","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>In this meta-analysis, Scopus, Web of Science, and PubMed were surfed for articles published by December 30<sup>th</sup>, 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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 2","pages":"112-122"},"PeriodicalIF":1.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Prophylactic Agents for Preventing Cardiotoxicity Induced Following Anticancer Agents: A Systematic Review and Meta-Analysis of Clinical Trials.\",\"authors\":\"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\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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. 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引用次数: 1
摘要
背景:蒽环类药物可以改善许多类型恶性肿瘤的生存，但使用蒽环类药物后的剂量依赖性和不可逆结果与心肌病有关。本荟萃分析旨在比较预防性药物在预防抗癌药物引起的心脏毒性方面的作用。方法:在本荟萃分析中，检索截至2020年12月30日发表的Scopus、Web of Science和PubMed文章。关键词:血管紧张素转换酶抑制剂(ACEI)、依那普利、卡托普利、血管紧张素受体阻滞剂、受体阻滞剂、美托洛尔、比索洛尔、异洛尔、他汀、缬沙坦、氯沙坦、依普利酮、伊达红霉素、奈比洛尔、二氢杨梅素、葡萄葡萄素、螺内酯、右唑嗪、抗氧化剂、心脏毒性、n-乙酰色胺、癌症、肿瘤、化疗、蒽环类药物、阿霉素、柔红霉素、柔红霉素、表柔红霉素、伊达红霉素、题目或摘要中的引射分数或它们的组合。结果:本次系统回顾和荟萃分析共纳入了728项研究中的17篇文章，共纳入了2674名患者。干预组基线、6个月、12个月的射血分数(EF)分别为62.52±2.48、59.63±4.85、59.42±4.53，对照组分别为62.81±2.58、57.69±4.32、58.60±4.58。通过两组比较，干预组6个月后EF升高0.40(标准化平均差值(SMD): 0.40, 95%可信区间(CI): 0.27, 0.54)，高于对照组。结论:本荟萃分析显示，蒽环类化疗患者预防性应用右唑嗪、受体阻滞剂、ACEI等心脏保护药物对LVEF具有保护作用，可防止EF下降。
Prophylactic Agents for Preventing Cardiotoxicity Induced Following Anticancer Agents: A Systematic Review and Meta-Analysis of Clinical Trials.
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 30th, 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.
期刊介绍：
Reviews on Recent Clinical Trials publishes frontier reviews on recent clinical trials of major importance. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: important Phase I – IV clinical trial studies, clinical investigations at all stages of development and therapeutics. The journal is essential reading for all researchers and clinicians involved in drug therapy and clinical trials.
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