Cardio-oncology & otherRandomised controlled trial

Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma

JACC CardioOncolPublished

  • Randomised controlled trial
  • prospective
  • multicentre
  • open-label
  • superiority
  • observer-blinded endpoints

Authors' conclusion

Adding enalapril to standard care during chemotherapy did not prevent cardiotoxicity in patients receiving high-dose anthracycline-based chemotherapy.

Study context

Population
Patients with breast cancer or non-Hodgkin lymphoma scheduled for 6 cycles of high-dose anthracycline chemotherapy (≥300 mg/m² doxorubicin equivalents)
Participants
111 patients
Comparison
Enalapril vs standard care
Primary endpoint
Myocardial injury by cardiac troponin T (≥14 ng/L)
Follow-up
During and 1 month after chemotherapy

Primary result

Myocardial injury (cardiac troponin T ≥14 ng/L)

Odds ratio

0.65

95% CI 0.23–1.78

Events by treatment group

Enalapril vs Standard care
OR 0.65 (95% CI 0.23–1.78)

As reported in the abstract

Further findings

OutcomeEnalaprilStandard careOR (95% CI)
Myocardial injury (cardiac troponin I >26.2 ng/L)47.2%45.3%1.10 (0.50–2.38)
Relative decline >15% from baseline in LV global longitudinal strain21.3%21.9%0.95 (0.33–2.74)
OutcomeEnalaprilStandard careEstimate
Absolute LVEF decline >10% to <50%4.1%0 events

Original publication

Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma. JACC CardioOncol. Published 27 August 2024. doi:10.1016/j.jaccao.2024.07.010

Summarised from the published abstract; every number is checked against it