The effect of ACE-I/ARBs and beta blockers on the development of cardiotoxicity in patients with breast cancer

Abstract Introduction Cardiovascular disease has become the leading cause of mortality among breast cancer survivors. Patients with who receive treatment anthracycline and trastuzumab therapies are at risk for development non-ischemic cardiomyopathy. The heart failure during chemotherapy administration often results in interruption these life saving therapies. Purpose We aim to investigate whether ACE Inhibitors/angiotensin receptor blockers (ACE-I/ARBs) beta-blockers can be used as primary prophylaxis prevent induced Methods This was a retrospective cohort study investigating women were diagnosed our medical center from January 2000 December 2021. endpoint cardiotoxicity after chemotherapy. Cardiotoxicity defined decrease LVEF by 5% or more less than 55% presence symptoms an asymptomatic 10% 55%. Cox-proportional hazard ratios conducted determine impact prophylactic ACE/ARBs on cardiotoxicity. Other baseline characteristics also investigated their potential endpoint. Results There 459 patients included which 70 met criteria Median follow up time 12 months average age 55 years. Among patients, 52% treated only trastuzumab, 34% anthracycline, 14% both Before initiated, 15% taking ACE-I/ARBs, 7% beta-blockers, combination ACE-I/ARBS beta-blockers. no significant protective benefits noted ACE-I/ARBs [HR: 0.49, 95% CI (0.17–1.4)], 0.50, (0.16–1.6)], 1.30, (0.44–3.9)]. Notably, there increased older 1.04, (1.01–1.1)], smokers within past 10 years 2.54, (1.41–4.6)], received therapy 2.52, (1.01–6.3)]. Conclusion Prophylactic use separately not associated beneficial reduction cardiomyopathy receiving Older age, smoking years, found risk. Further studies needed etiology how may augment cardiotoxic effects this population. Funding Acknowledgement Type funding sources: None.