Citation | Study design | Type(s) of malignancy | Major findings |
Beta blockers |
Kalay 2006[1] | - Randomized
- Single-blind
- Placebo-controlled
- Carvedilol 12.5 mg daily (n = 25)
- Placebo (n = 25)
| | - Fewer deaths among those receiving carvedilol than placebo (one versus four, respectively).
- Those receiving carvedilol did not experience a significant decline in LVEF (70.5 to 69.7%, p = 0.3), while those receiving placebo did (68.9 to 52.3%, p = 0.001).
|
Kaya 2013[2] | - Randomized
- Double-blind
- Placebo-controlled
- Nebivolol 5 mg daily (n = 27)
- Placebo (n = 18)
| | - Those receiving nebivolol did not experience significant worsening of echocardiographic parameters at six months while those receiving placebo did:
- Mean LVEF (%):
- Nebivolol: 65.6 → 63.8
- Placebo: 66.6 → 57.5
- Mean LVEDD (mm):
- Nebivolol: 47.0 → 47.1, p = 0.93
- Placebo: 47.2 → 52.0, p = 0.01
- Mean LVESD (mm):
- Nebivolol: 30.4 → 31.0, p = 0.20
- Placebo: 29.7 → 33.4, p = 0.01
- Mean NT-proBNP (pmol/L):
- Nebivolol: 147 → 152, p = 0.77
- Placebo: 144 → 204, p = 0.01
|
Georgakopoulos 2010[3] | - Randomized
- Metoprolol (formulation not specified) (n = 42)
- Enalapril (n = 43)
- No additional treatment (n = 40)
| | - No difference in heart failure, LVEF, LVEDD, LVESD, or other echocardiographic parameters with metoprolol versus placebo.
|
Gulati 2016[4] | - Randomized
- Placebo-controlled
- Double-blind
- 2 × 2 factorial
- n = 130
- Metoprolol succinate (target dose 100 mg daily) (n = 58)
- Candesartan (target dose 325 mg daily) (n = 60)
| | - No significant effect on change in LVEF with metoprolol versus placebo (preliminary results).
|
Angiotensin inhibitors (ACEIs/ARBs) |
Georgakopoulos 2010[3] | - Randomized
- Metoprolol (n = 42)
- Enalapril (n = 43)
- No additional treatment (n = 40)
| | - No difference in heart failure, LVEF, LVEDD, LVESD, or other echocardiographic parameters with enalapril versus placebo.
|
Gulati 2016[4] | - Randomized
- Placebo-controlled
- Double-blind
- 2 × 2 factorial
- n = 130
- Metoprolol succinate (target dose 100 mg daily) (n = 58)
- Candesartan (target dose 325 mg daily) (n = 60)
| | - Those receiving candesartan did not experience a decline in LVEF (0.8, CI –0.4 to 1.9) while those receiving placebo did (2.6, CI 1.5-3.8, p = 0.026) (preliminary results of intention-to-treat analysis).
|
Combined beta blockade and angiotensin inhibition |
Bosch 2013[5] | - Randomized
- Enalapril (target dose 10 mg twice daily) and carvedilol (target dose 25 mg twice daily) (n = 45)
- No additional treatment (n = 45)
| | - Those receiving candesartan did not experience a decline in LVEF while those receiving placebo did (3.1% decrease, p = 0.035).
- Incidence of death or heart failure was lower in the enalapril/carvedilol arm compared with those receiving placebo (6.7 versus 22%, p = 0.036).
|
Dexrazoxane |
van Dalen 2011[6] | - Meta-analysis (10 randomized controlled trials)
- Dexrazoxane (n = 799)
- Placebo (n = 285)
- No additional treatment (n = 535)
| - Breast cancer
- Leukemia
- Other
| - Risk of clinical heart failure was lower with dexrazoxane versus placebo (RR 0.18, CI 0.1-0.32, p<0.001).
- No effect on overall survival.
|
Statins |
Acar 2011[7] | - Randomized
- Atorvastatin 40 mg daily (n = 20)
- No additional treatment (n = 20)
| | - Those receiving atorvastatin did not experience worsening echocardiographic parameters while those receiving placebo did:
- Mean LVEF (%):
- Atorvastatin: 61.3 → 62.6
- Control: 62.9 → 55.0
- p value for comparison of mean change <0.001
- Mean LVEDD (mm):
- Atorvastatin: 46.5 → 46.3
- Control: 47.2 → 49.2
- p value for comparison of mean change = 0.021
- Mean LVESD (mm):
- Atorvastatin: 30.9 → 29.6
- Control: 30.3 → 32.3
- p value for comparison of mean change <0.001
|
Seicean 2012[8] | - Retrospective
- Observational
- Statin prescribed for other indication (n = 67)
- Propensity-matched controls (n = 134)
| | - Risk of heart failure hospitalization was lower for those receiving a statin than those receiving placebo (HR 0.3, CI 0.1-0.9, p<0.03).
|