Eur Heart J:BBs和ACEI/ARBs用于预防乳腺癌患者因蒽环类药物或曲妥珠单抗引起的左心室功能障碍

2021-12-25 MedSci原创 MedSci原创

在曲妥珠单抗和含蒽环类药物治疗期间,与安慰剂相比,服用BB和ACEI/ARB治疗都与保持LVEF相关,表明两者对心脏都是有益的。

经常用于治疗乳腺癌的曲妥珠单抗和蒽环类药物可能会损害心肌功能,并降低左心室射血分数(LVEF),可能导致心力衰竭。随机对照试验(RCT)评估了β受体阻滞剂(BB)、血管紧张素受体阻滞剂(ARB)和血管紧张素转换酶抑制剂(ACEI)对曲妥珠单抗和蒽环类药物相关心脏毒性的影响。

近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员报告了在乳腺癌患者中开展的RCT的荟萃分析结果。

该研究的主要分析是明确接受曲妥珠单抗或蒽环类药物治疗的患者接受BBs和ACEI/ARBs治疗对LVEF的影响。研究人员对接受曲妥珠单抗和蒽环类药物治疗的患者服用BBs或ACEI/ARBs治疗对LVEF的效应进行了次要分析。截至2021年3月31日,研究人员在PubMed、Embase和CENTRAL数据库中使用检索词“ARBs、ACEIs、BBs、蒽环类药物、曲妥珠单抗和乳腺癌”,并仅纳入了RCT。研究人员进行了荟萃分析以估计在随访时干预组和安慰剂组之间LVEF的平均差异(MD)。

该荟萃分析总共纳入了九项RCT(n=1362)。所有患者均为女性。在接受曲妥珠单抗和蒽环类药物治疗期间,服用BBs和ACEI/ARBs治疗可减轻LVEF的下降[MD为2.4;95%置信区间(CI)为0.3-4.2和MD为1.5;95%CI为–0.6到3.7]。在接受曲妥珠单抗治疗的患者中,与安慰剂相比,服用BB或ACEI/ARB治疗的患者LVEF显著高于(MD:2.3;95%CI:0.0-4.6),但在接受蒽环类药物的患者中则不然(MD为1.9;95%CI为–0.5至4.2).

由此可见,在曲妥珠单抗和含蒽环类药物治疗期间,与安慰剂相比,服用BB和ACEI/ARB治疗都与保持LVEF相关,表明两者对心脏都是有益的。

原始出处:

Christian Lewinter,et al.A systematic review and meta-analysis of beta-blockers and renin–angiotensin system inhibitors for preventing left ventricular dysfunction due to anthracyclines or trastuzumab in patients with breast cancer.European Heart Journal.2021.https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehab843/6482048?redirectedFrom=fulltext

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    2022-09-01 shanyongle
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    2021-12-27 zhaojie88
  4. 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04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521711, encodeId=b7e11521e1161, content=<a href='/topic/show?id=a59d88340d2' target=_blank style='color:#2F92EE;'>#蒽环类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88340, encryptionId=a59d88340d2, topicName=蒽环类)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97d111387900, createdName=shijzhiewnjhch, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563567, encodeId=ef15156356e1d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], 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  5. [GetPortalCommentsPageByObjectIdResponse(id=1648195, encodeId=b0201648195bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, createdName=linlin2320, createdTime=Tue Apr 12 04:00:33 CST 2022, time=2022-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656089, encodeId=55ca16560891e, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, 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04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521711, encodeId=b7e11521e1161, content=<a href='/topic/show?id=a59d88340d2' target=_blank style='color:#2F92EE;'>#蒽环类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88340, encryptionId=a59d88340d2, topicName=蒽环类)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97d111387900, createdName=shijzhiewnjhch, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563567, encodeId=ef15156356e1d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571311, encodeId=360b15e131102, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1648195, encodeId=b0201648195bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, createdName=linlin2320, createdTime=Tue Apr 12 04:00:33 CST 2022, time=2022-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656089, encodeId=55ca16560891e, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, 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  7. [GetPortalCommentsPageByObjectIdResponse(id=1648195, encodeId=b0201648195bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, createdName=linlin2320, createdTime=Tue Apr 12 04:00:33 CST 2022, time=2022-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656089, encodeId=55ca16560891e, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, 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04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521711, encodeId=b7e11521e1161, content=<a href='/topic/show?id=a59d88340d2' target=_blank style='color:#2F92EE;'>#蒽环类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88340, encryptionId=a59d88340d2, topicName=蒽环类)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=97d111387900, createdName=shijzhiewnjhch, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563567, encodeId=ef15156356e1d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571311, encodeId=360b15e131102, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-27 redcrab
  8. 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  9. 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attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571311, encodeId=360b15e131102, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Dec 27 04:00:33 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-27 slcumt
  10. 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