Comparing Renin-Angiotensin-Aldosterone Blockade Regimens for Long-Term Chemotherapy-Related Cardiac Dysfunction: A Network Meta-Analysis.
Jiaqi LiAinsley Ryan Yan Bin LeeAreeba TariqGrace LauChun En YauLi Ling TanSara Moiz TyeballyMatilda Xinwei LeeChieh Yang KooChing-Hui SiaPublished in: Cardiovascular drugs and therapy (2023)
Nineteen studies reported the effects of 13 interventions (N = 1905 patients). Only enalapril (RR 0.05, 95% CI 0.00-0.20) was associated with reduced risk of patients developing significant decline in LVEF relative to placebo. Subgroup analysis showed that the beneficial effect of enalapril was driven by protection against anthracycline-associated toxicity. In addition, no RAAS-inhibiting agents showed efficacy in protection against treatment with both anthracycline and trastuzumab. The use of RAAS inhibition therapy did not conclusively impact on other markers of cardiac function, including left ventricular diastolic function and cardiac biomarkers.
Keyphrases
- left ventricular
- end stage renal disease
- ejection fraction
- chronic kidney disease
- heart failure
- newly diagnosed
- oxidative stress
- peritoneal dialysis
- blood pressure
- squamous cell carcinoma
- randomized controlled trial
- angiotensin ii
- prognostic factors
- acute myocardial infarction
- coronary artery disease
- signaling pathway
- bone marrow
- atrial fibrillation
- angiotensin converting enzyme
- open label
- patient reported