Long-Term Effects of Sacubitril/Valsartan After Chemotherapy for Breast Cancer in Patients With Chronic heart Failure
https://doi.org/10.35401/2541-9897-2024-9-1-37-44
Abstract
Background: As the survival of patients with malignant neoplasms is improving, the urgent need for cardioprotective agents to counteract toxic effects of chemotherapy is growing.
Objective: To compare the cardioprotective efficacy of sacubitril/valsartan and candesartan in women with chronic heart failure and baseline reduced left ventricular ejection fraction (LVEF) during a 5-year prospective follow-up after chemotherapy for breast cancer.
Materials and methods: In this randomized study, 127 women with chronic heart failure and reduced LVEF after radical surgical treatment of breast cancer received potentially cardiotoxic adjuvant polychemotherapy (fluorouracil+ doxorubicin + cyclophosphamide). In addition, the patients received sacubitril/valsartan at a dose of up to 97/103 mg twice daily (n = 63) or candesartan at a dose of up to 32 mg once daily (n = 65), and this treatment was monitored for 5 years.
Results: The combination of sacubitril/valsartan was significantly superior to candesartan in improving left ventricular function and reducing the burden of ventricular arrhythmias and the risk of cardiovascular death (P = .039) at the long-term follow-up. Sacubitril/valsartan group and candesartan group did not differ in terms of mortality due to breast cancer progression or recurrence (P = .628).
Conclusions: Sacubitril/valsartan can be considered an effective and safe option for protecting the cardiovascular system during potentially cardiotoxic polychemotherapy for breast cancer in patients with chronic heart failure and baseline reduced LVEF.
About the Authors
S. G. Kanorskiy
Kuban State Medical University
Russian Federation
Russian Federation
Sergey G. Kanorskiy, Dr. Sci. (Med.), Professor, Head of Therapy Department No. 2, Faculty of Continuing Professional Development and Retraining
ulitsa M. Sedina 4, Krasnodar, 350063
V. P. Pavlovets
Multidisciplinary Clinic “MAMME”
Russian Federation
Russian Federation
Vadim P. Pavlovets, Cardiologist
Krasnodar
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Review
For citations:
Kanorskiy S.G., Pavlovets V.P. Long-Term Effects of Sacubitril/Valsartan After Chemotherapy for Breast Cancer in Patients With Chronic heart Failure. Innovative Medicine of Kuban. 2024;(1):37-44. (In Russ.) https://doi.org/10.35401/2541-9897-2024-9-1-37-44
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