Al-Hasnawi Zeineb, Hasan Hawraa Mohammed, Abdul Azeez Jaafar Mohammed, Kadhim Naam, Shimal Aya Ahmed, Sadeq Maryam Hussein, Mahood Noor Al-Huda Ali Motashar, Al-Qara Ghuli Abdulmelik A N, Hussein Ahmed Safaa, Prajjwal Priyadarshi, Jain Hritvik, Goyal Aman, Amir Omniat
College of Medicine, University of Kufa, Najaf, Iraq.
Al Kadhimiyah Teaching Hospital, Baghdad, Iraq.
Ann Med Surg (Lond). 2024 Oct 16;86(12):7212-7220. doi: 10.1097/MS9.0000000000002668. eCollection 2024 Dec.
Chemotherapy-induced cardiotoxicity (CIC) is a significant challenge in cancer treatment, leading to heart failure and myocardial infarction. With rising cancer survival rates, the long-term cardiovascular health of survivors has gained importance. While several cardioprotective medications have been studied to mitigate chemotherapy's harmful effects on the heart, more research is needed to confirm their effectiveness and optimal use.
This review synthesizes evidence on cardioprotective drugs in managing CIC. The authors conducted a comprehensive literature search of peer-reviewed articles, clinical trials, and meta-analyses published between January 2000 and May 2024. Studies were selected based on relevance, quality, and focus on mechanisms, efficacy, and clinical outcomes of cardioprotective agents such as beta-blockers, ACE inhibitors, ARBs, statins, and dexrazoxane.
Cardioprotective medications show potential in alleviating the impact of chemotherapy on heart function. Beta-blockers and ACE inhibitors effectively reduce heart failure incidence and improve cardiac outcomes. Statins, with their anti-inflammatory and antioxidative properties, and dexrazoxane, which reduces anthracycline-induced cardiotoxicity, also show promise. However, variability in study designs, patient groups, and chemotherapy treatments complicates the establishment of standardized treatment protocols.
Cardioprotective drugs hold significant promise in managing CIC and improving cardiac outcomes for cancer patients. Current evidence supports the efficacy of beta-blockers, ACE inhibitors, statins, and dexrazoxane. Further research is needed to establish standardized protocols, evaluate long-term safety, and optimize treatment timing. Integrating cardioprotective strategies into oncological care can enhance the quality of life and prognosis for cancer survivors.
化疗引起的心脏毒性(CIC)是癌症治疗中的一项重大挑战,可导致心力衰竭和心肌梗死。随着癌症生存率的提高,幸存者的长期心血管健康变得越发重要。虽然已经对几种心脏保护药物进行了研究,以减轻化疗对心脏的有害影响,但仍需要更多研究来证实其有效性和最佳使用方法。
本综述综合了关于心脏保护药物治疗CIC的证据。作者对2000年1月至2024年5月发表的同行评审文章、临床试验和荟萃分析进行了全面的文献检索。根据相关性、质量以及对β受体阻滞剂、ACE抑制剂、ARB、他汀类药物和右丙亚胺等心脏保护剂的作用机制、疗效和临床结果的关注程度来选择研究。
心脏保护药物在减轻化疗对心脏功能的影响方面显示出潜力。β受体阻滞剂和ACE抑制剂可有效降低心力衰竭的发生率并改善心脏预后。具有抗炎和抗氧化特性的他汀类药物以及可降低蒽环类药物引起的心脏毒性的右丙亚胺也显示出前景。然而,研究设计、患者群体和化疗治疗方法的差异使得制定标准化治疗方案变得复杂。
心脏保护药物在管理CIC和改善癌症患者的心脏预后方面具有重大前景。目前的证据支持β受体阻滞剂、ACE抑制剂、他汀类药物和右丙亚胺的疗效。需要进一步研究以建立标准化方案、评估长期安全性并优化治疗时机。将心脏保护策略纳入肿瘤护理可以提高癌症幸存者的生活质量和预后。