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Journal Article Review Epublish 3 citations

PubMed: 39649884 DOI: 10.1097/MS9.0000000000002668

Cardioprotective strategies in the management of chemotherapy-induced cardiotoxicity: current approaches and future directions.

Ann Med Surg (Lond) 86(12):7212-7220

Authors: Zeineb Al-Hasnawi, Hawraa Mohammed Hasan, Jaafar Mohammed Abdul Azeez, Naam Kadhim, Aya Ahmed Shimal, Maryam Hussein Sadeq, Noor Al-Huda Ali Motashar Mahood, Abdulmelik A N Al-Qara Ghuli, Ahmed Safaa Hussein, Priyadarshi Prajjwal, Hritvik Jain, Aman Goyal, Omniat Amir

Affiliations

  • College of Medicine, University of Kufa, Najaf, Iraq.
  • Al Kadhimiyah Teaching Hospital, Baghdad, Iraq.
  • Babylon College of Medicine, University of Babylon, Babil, Iraq.
  • College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
  • College of Medicine, University of Diyala, Diyala, Iraq.
  • Ulyanovsk State University, Ulyanovsk State Medical University, Ulyanovsk, Russia.
  • Bharati Vidyapeeth Deemed University, Pune, India.
  • All India Institute of Medical Sciences, Jodhpur, India.
  • Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India.
  • Almanhal Academy for Science, Khartoum, Sudan.

Abstract

Background

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.

Methodology

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.

Results and discussion

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.

Conclusion

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.

MeSH

Heart Failure, Pharmaceutical Preparations, Heart, Neoplasms, Drug Therapy, Cardiotoxicity, Research, Therapeutics, Dexrazoxane, Hydroxymethylglutaryl-Coa Reductase Inhibitors, Chemotherapy

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