ArticleJournal of Korean medical science2026
Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer Patients Receiving Combination Therapy of Candesartan and Carvedilol for Primary Prevention: A Prospective Longitudinal Study.
Article in Journal of Korean medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe use of renin-angiotensin system inhibitors and beta-blockers for primary prevention of cancer therapy-related cardiac dysfunction (CTRCD) remains controversial. This study investigated the incidence, severity and predictors of CTRCD under cardioprotective therapy with a combination of candesartan and carvedilol.
methodsWe included 851 subjects with a normal left ventricular ejection fraction (LVEF) (> 55%) who were scheduled to receive chemotherapy and/or trastuzumab (TZ) for breast cancer. Candesartan plus carvedilol were administered on the first day of chemotherapy or TZ and continued during and after cancer therapy. Patients underwent serial real-time three-dimensional (3D) echocardiograms before initiation of chemotherapy or TZ, every 3 months during cancer therapy, 6 months after completion of cancer therapy, and annually thereafter. CTRCD was defined by the European Society of Cardiology definitions using LVEF and global longitudinal strain (GLS) derived from 3D-echocardiographic images.
resultsA total of 577 patients (257 anthracycline [AC]/non-TZ, 111 AC/TZ, 47 non-AC/TZ, and 162 non-AC/non-TZ) were analyzed. During a median follow-up of 17.9 months, 24.6% of patients (28.8% AC/non-TZ vs. 43.2% AC/TZ vs. 21.3% non-AC/TZ vs. 6.2% non-AC/non-TZ;
conclusionIn a primary prevention strategy with combined therapy of candesartan and carvedilol, asymptomatic CTRCD was still not uncommon and hypertension was a strong risk factor of CTRCD in breast cancer patients treated with cardiotoxic cancer therapy.
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