09 December 2019

Cancer patients could benefit from being prescribed common heart drugs to reduce the chances of cardiovascular disease caused by cancer treatment, a conference has heard.

A poster presented last week at EuroEcho 2019, a scientific congress of the European Society of Cardiology (ESC), has found that cancer patients could be routinely given beta-blockers, angiotensin converting enzyme (ACE) inhibitors, or angiotensin II receptor blockers (ARBs).

Dr Sergio Moral, of Hospital Universitari Josep Trueta and Hospital Santa Caterina, Girona, Spain, told delegates that for every ten patients with breast or haematological cancer treated with heart drugs, one case of cardiotoxicity could be avoided.

The systematic review searched for the best available evidence to establish if using beta-blockers, ACE inhibitors, and/or ARBs was associated with a drop in cardiotoxicity in patients being treated for breast or haematological cancer.

The meta-analysis included nine randomised controlled trials, the main treatment for which was anthracycline chemotherapy. Some also administered adjuvant treatment such as trastuzumab for breast cancer.

A total of 913 patients were enrolled, 534 of whom received heart drugs: 337 a beta-blocker, 152 an ACE inhibitor or ARB, and 45 a beta-blocker and ACE inhibitor. They were compared with a control group of 379 people.

In the following 12 months, 12% of patients (108) developed cardiotoxicity. However, patients receiving cardioprotective treatment had a significantly lower risk of cardiotoxicity, equating to a relative risk of 0.381 – a reduction of more than 60%.

Dr Moral said: “Cardioprotective medications are not habitually prescribed in patients with cancer and our study suggests that they should be considered.

“Cancer and cardiovascular disease share common risk factors, which also influence susceptibility to cardiotoxicity. Consequently, cancer patients are advised to eat healthily, quit smoking, control their weight, and exercise.

“More research is needed to identify which patients benefit the most from cardioprotective therapy, which medication is most effective and at what dose, and the optimal duration of prophylaxis.”


Source: EuroEcho 2019