PHARMACOLOGICAL PREVENTION OF CHEMOTHERAPY-INDUCED CARDIOTOXICITY: COMPARATIVE EVIDENCE ON BETA-BLOCKERS AND ACE INHIBITORS IN ONCOLOGY
DOI:
https://doi.org/10.56238/levv16n53-093Keywords:
Cardiotoxicity, Beta-Blockers, ACE Inhibitors, Cardio-OncologyAbstract
Introduction: Chemotherapy remains one of the most effective strategies for cancer treatment but frequently results in cardiac dysfunction, particularly in patients exposed to anthracyclines or targeted agents with cardiotoxic potential. Preventive pharmacotherapy with beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has emerged as a viable approach to preserving myocardial function in this population.
Objective: To analyze the comparative efficacy of beta-blockers and ACE inhibitors, individually and in combination, in the prevention of chemotherapy-induced cardiotoxicity in cancer patients at high cardiovascular risk. Secondary objectives included assessment of safety, tolerability, and long-term effects on cardiac remodeling.
Methods: A systematic literature review was conducted in PubMed, Scopus, Web of Science, Cochrane Library, ClinicalTrials.gov, and LILACS. Studies published between 2015 and 2025 were included. Randomized controlled trials, cohort studies, and meta-analyses addressing preventive cardioprotective pharmacotherapy were selected.
Results and Discussion: Across 30 eligible studies, beta-blockers such as carvedilol and bisoprolol, as well as ACE inhibitors including enalapril and lisinopril, significantly reduced the incidence of left ventricular ejection fraction decline and biomarker elevation. Combination therapy provided synergistic protection and reduced chemotherapy discontinuation due to cardiac dysfunction. Preventive regimens demonstrated excellent safety and tolerability profiles.
Conclusion: Beta-blockers and ACE inhibitors constitute effective and safe pharmacological strategies for the prevention of chemotherapy-induced cardiotoxicity. Their routine inclusion in cardio-oncology protocols may improve cardiac outcomes, treatment continuity, and overall survivorship.
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References
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