Arq. Bras. Cardiol. 2023; 120(5): e20230280
Renin-Angiotensin System Inhibition and Beta Blockade Adrenergic May Be Useful to Attenuate Cardiotoxicity by Anthracyclines
This Short Editorial is referred by the Research article "Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis".
Cardiotoxicity related to the use of anthracyclines is a major concern in oncology, as it can increase the morbidity of many patients receiving chemotherapy for various types of cancer. This toxicity can lead to left ventricular systolic dysfunction and, therefore, a higher incidence of heart failure, which can result in mortality in severe cases. A better understanding of the mechanisms involved and a better definition of diagnostic methods have provided significant advances in detecting this complication. However, there is still no consensus on the most accurate biomarkers for early identification of cardiotoxicity. Despite this, troponin measurement after each chemotherapy cycle can be a valid tool to indicate immediate intervention. ,
Manifestations of cardiotoxicity may remain restricted to myocardial cell damage detectable only by measuring circulating biomarkers or vary between silent ventricular dysfunction and clinically manifest heart failure. Strategies to avoid or at least attenuate anthracycline-induced cardiotoxicity are essential to improve the prognosis of patients using this class. The current recommendations include treating pre-existing cardiovascular risk factors, – choosing less cardiotoxic analogues, and administering low cumulative doses of anthracyclines. ,
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