EUROECHO: Heart Drugs May Block Chemo Damage
|By Crystal Phend, Senior Staff Writer, MedPage Today
December 12, 2011
|MedPage Today Action Points
BUDAPEST — The combination of statin plus ACE inhibitor could be cardioprotective for cancer patients who need anthracycline chemotherapy, a small prospective study suggested.
Several measures of left ventricular diastolic function deteriorated significantly less with prophylactic rosuvastatin (Crestor) and lisinopril (Prinivil, Zestril) given during standard anthracycline-based chemotherapy for a variety of cancer types, Liliana Radulescu, MD, of the University of Medicine in Cluj-Napoca, Romania, and colleagues found.
The effect was minimal for left ventricular systolic function, which dropped similarly in both groups, they reported here at the European Association of Echocardiography meeting.
“The findings are encouraging but must be confirmed in larger numbers of patients,” commented Patricia Pellikka, MD, of the Mayo Clinic in Rochester, Minn., and president-elect of the American Society of Echocardiography.
Whether the effect can be confirmed or not, comprehensive echocardiographic assessment of both systolic and diastolic function is key in cancer patients who are receiving cardiotoxic chemotherapy, she told MedPage Today.
Radulescu’s group tried to reduce that risk for a group of 26 patients receiving epirubicin (Ellence) doses up to 500 mg/m2 for various types of cancer by prophylactic administration of 10 mg lisinopril and 10 mg rosuvastatin.
The prospective study included another 31 age- and gender-matched cancer patients as controls not getting the heart drugs.
Doppler echocardiography assessed cardiac function before and after chemotherapy. None of the patients had any prior cardiovascular disease.
Left ventricular ejection fraction reflecting systolic function dropped in both groups — from 62.73% to 58.22% with cardioprotective therapy and from 63.89% to 57.51% without it, which was not significantly different between groups (P=0.21).
But the story was different for left ventricular diastolic function.
The group that got a statin plus ACE inhibitor saw significantly less decrease in left ventricular contractility and less increase in atrial peak filling.
Other diastolic function advantages for the cardioprotective therapy versus control groups for change from baseline to post-chemotherapy were:
The researchers acknowledged that further studies with larger numbers of patients are needed.
Animal studies have pointed to oxidative stress and inflammation as the potential cause of cardiac damage from anthracyclines, noted coauthor Andreea Parv, MD, also of the University of Medicine in Cluj-Napoca.
“Both ACE inhibitors and statins are known to play an important role in reducing oxidative stress and inflammation at the level of the heart muscle cells,” she said in a press release.
The researchers provided no information on conflicts of interest.
Primary source: European Association of Echocardiography
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