Introduction: The purpose of this study is to investigate the preventive effect of candesartan or carvedilol in the anthracycline-induced subclinical cardiotoxicity (SC).
Methods: Two hundred seventy four patients from prospective registry for prediction and prevention of chemotherapy induced cardiotoxicity in breast cancer of our institution were selected. All patients were administered candesartan or carvedilol concomitantly with doxorubicin contained chemotherapy. One hundred four patients were treated with candesartan (CDST group, n=104) and ninety three patients were treated with carvedilol (CVDL group, n=93). Seventy seven patients were treated with candesartan and cavedilol combination (CDST+CVDL, n=77). One hundred six patients who did not take candesartan nor cavedilol were selected for control (CONT, n=106). Cardiac function of patients were evaluated by transthoracic echocardiography (TTE) before chemotherapy for baseline and followed up at least twice during chemotherapeutic period. The incidence of subclinical cardiotoxicity (SC) was evaluated.
Results: In prospective registry, twenty out of 274 patients (7.3%) developed SC during follow up period. The incidence of SC was significantly lower than CONT (20.8%, Table 2). Incidences of each group are demonstrated in Table 1. The combination group did not showed more protective effect than monotherapy groups. The incidence SC in CDST group was lower than other groups. Left ventricular ejection fraction (LVEF) of CONT group showed gradual decrement during follow up (Table 2). After chemotherapy, LVEF of CONT was significantly lower than other groups. CVDL group showed early reduction of LVEF compared to CDST treated groups.
Conclusion: Concomitant administration of candesartan or carvedilol with chemotherapy can reduce incidence of SC and aggravation of LV dysfunction. CDST was most protective effect and combination therapy did not showed additional effect on protection of development SC.