Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Natural Progression of Left Ventricular Function Following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

Ainsley Ryan Yan Bin Lee
,
Chun En Yau
ORCID logo ,
Chen Ee Low
,
Jiaqi Li
,
Sara Moiz Tyebally
,
Weiqin Lin
,
Li-Ling Tan
,
Chia-Te Liao
,
Wei-Ting Chang
,
Matilda Xinwei Lee
,
Chieh-Yang Koo
ORCID logo ,
Ching-Hui Sia
* ORCID logo
Version 1 : Received: 14 December 2022 / Approved: 20 December 2022 / Online: 20 December 2022 (04:26:21 CET)

A peer-reviewed article of this Preprint also exists.

Lee, A.R.Y.B.; Yau, C.E.; Low, C.E.; Li, J.; Tyebally, S.M.; Lin, W.; Tan, L.-L.; Liao, C.-T.; Chang, W.-T.; Lee, M.X.; Koo, C.-Y.; Sia, C.-H. Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis. Cancers 2023, 15, 512. Lee, A.R.Y.B.; Yau, C.E.; Low, C.E.; Li, J.; Tyebally, S.M.; Lin, W.; Tan, L.-L.; Liao, C.-T.; Chang, W.-T.; Lee, M.X.; Koo, C.-Y.; Sia, C.-H. Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis. Cancers 2023, 15, 512.

Abstract

Background: Anthracyclines form the backbone of many systemic chemotherapy regimens but dose-limiting cardiotoxicity can also lead to reduction in cardiac function and an increased risk of heart failure. Methods: This review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42022373496). Results: 26 studies met the eligibility criteria including a total of 910 patients. Overall reduction in pooled mean left ventricular ejection fraction (LVEF) post‐anthracyclines in the placebo arms of included randomised-controlled trials was 4.6% (95% CI, 2.7 to 6.6). The trend in LVEF showed a progressive decline until approximately 180 days after which there was no significant change. Those receiving a cumulative anthracycline dose 300 mg/m2 experienced a more profound reduction. The risk of a 10% absolute decline in LVEF from baseline or decline to an LVEF below 50%, the overall pooled risk was 16% (95% CI: 11 to 21; I2 = 77%). Sensitivity analyses by baseline LVEF and trastuzumab treatment status did not yield significant differences. Conclusion: While the mean LVEF decline in patients without cardioprotective therapy was clinically small, a vulnerable subset experienced significant impairment. Further research to best identify those who benefit most from cardioprotective therapies when receiving anthracyclines are required.

Keywords

Anthracyclines; Cardiotoxicity; Heart failure; Chemotherapy toxicity; Cardio-Oncology; Breast cancer; Haematological cancer

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download PDF Download Supplementary

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Supplementary Files Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.