| Objective:Anthracycline-containing chemotherapy is associated with irreversible cardiovascular toxicity.It is well known that beta blockers are currently recommended as first-line drugs for improving cardiac function.However,the effects of beta blocker on cardiac preservation and the duration of beta blocker intervention therapy in anthracycline-treated patients remain unclear.Method:We systematically searched Pub Med,Cochrane,Embase and for randomized controlled trials(published between January,2000 and January,2019)to determine the effectiveness of cardiac preservation of beta blocker in anthracycline-treated patients by accessing the change in left ventricular ejection fraction(LVEF)from pre-to post-chemotherapy.In addition,we conducted subgroup analysis based on the duration of beta blocker cardioprotective intervention and accumulative anthracycline dose.Results:11 RCTs were finally included.Beta blockers were associated with a significant smaller drop in the LVEF change(MD=2.87,95%CI 0.64 to 5.11,p=0.01)compared to control groups.Besides,a subgroup analysis according to duration of beta blocker-based cardioprotective intervention(<6 months vs=6 months)showed significant subgroup difference in the LVEF change(MD=-0.05,95%CI-0.91 to 0.81,p=0.91;MD=6.48,95%CI 2.44 to 10.52,p=0.002).An additional subgroup analysis according to accumulative anthracycline dose showed statistically significant difference in the LVEF change(MD=4.61,95%CI 0.78 to 8.45,p=0.02)with moderate accumulative dose of anthracycline(doxorubicin between 250 and 400 mg/m~2).Conclusions:Prophylactic administration of beta blocker-based cardioprotective therapy may be beneficial to the myocardial preservation in anthracycline-treated patients.And long-term use of beta blocker appears to have a positive effect on ameliorating anthracycline-induced cardiomyopathy,especially in patients exposed to moderate accumulative doses of anthracycline. |
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