The Efficacy Of Carvedilol And Enalapril For The Anthracycline-induced Cardiotoxicity

【Objective】Anthracycline,due to the dose-related cardiotoxicity,is limited in the use of tumor chemotherapy.Cardioprotective agents using in heart failure like carvedilol and enalapril are considered to prevent the cardiotoxicity.This meta-analysis was built to find their true curative effect and confirm an effective therapy strategy to prevent and cure anthracycline dose-related cardiotoxicity.【Methods】From inception to May 2020,we search the literature through different foreign databases,our study totally included 13 randomized controlled trials covering 1097 patients and used a random-effects to compute odds ratios(ORs)with 95%confidence intervals(CIs)to make a meta-analysis.【Results】Overall,it demonstrated that the LVEF cardiotoxicity events happened in the experimental-treated group was lower than in the placebo-treated group with statistical significance(6.0%vs 15.4%;ORs:0.32;95%CIs:0.15 to 0.71;p=0.005;I~2=55%).Carvedilol tended to perform better than enalapril(Carvedilol-group:8.3%vs 11.4%;ORs:0.69;95%CIs:0.39 to 1.22;p=0.21;I~2=0%;Enalapril-group:1.6%vs 5.2%;ORs:0.39;95%CIs:0.08 to 1.86;p=0.24;I~2=0%).Besides,contrast to the experimental group,we found obvious reductions of LVEF in the placebo group(MD:4.58%;95%CIs:2.47 to 6.70;p<0.0001;I~2=96%).In the subgroup analysis of LVEF changing,there did not have a significance in both group(Carvedilol-group:MD:2.49%;95%CIs:0.37to 4.60;p=0.02;I~2=88%;Enalapril-group:MD:6.22%;95%CIs:-0.93 to 13.37;p=0.09;I~2=92%),but carvedilol perform a better tendency than enalapril.【Conclusion】Prophylactic and therapeutic use of carvedilol tended to behave better than enalapril,especially in the reduction of LVEF.Both of them had a positive function.