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91 Prophylactic use of carvedilol to prevent ventricular dysfunction in patients with cancer treated with doxorubicin
  1. Abdulhalim Kinsara1,
  2. Ahmed abuosa2,
  3. Ayman Elsheikh2,
  4. Kahekashan Qureshi2,
  5. Mohammed Abrar2,
  6. Mona Kholeif2,
  7. Abdulwahab Andejani2,
  8. Adel Ahmed2,
  9. John Cleland3
  1. 1King Saud bin Abdulaziz University for Health Sciences, COMJ. King Abdul Aziz Medical City -WR. King, Jeddah, Saudi Arabia
  2. 2King Saud bin Abdulaziz University for Health Sciences, COMJ. King Abdul Aziz Medical City -WR. King
  3. 3National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London


Aims Deterioration in ventricular function is often observed in patients treated with anthracyclines for cancer. There is a paucity of evidence on interventions that might provide cardio-protection. We investigated whether carvedilol can prevent doxorubicin-induced cardiotoxicity and whether any observed effect is dose related.

Methods and results A prospective, randomised, double-blind study in patients treated with doxorubicin, comparing placebo (n=38) with different doses of carvedilol [6.25 mg/day (n=41), 12.5 mg/day (n=38) or 25 mg/day (n=37)]. The primary endpoint was the measured change in left ventricular ejection fraction (LVEF) from baseline to 6 months. LVEF decreased from 62%±5% at baseline to 58%±7% at 6 months (p=0.002) in patients assigned to placebo but no statistically significant changes were observed in any of the 3 carvedilol groups. At 6 months, only one of 116 patients (1%) assigned to carvedilol had an LVEF <50% compared to four of the 38 assigned to placebo (11%), (p=0.013). No significant differences were noted between carvedilol and placebo in terms of the development of diastolic dysfunction, clinically overt heart failure or death.

Conclusions Carvedilol might prevent deterioration in LVEF in cancer patients treated with doxorubicin. This effect may not be dose related within the studied range

  • Doxorubicin
  • Carvedilol
  • Cardiomyopathy

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