Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma: The PROACT Clinical Trial
Primary result · Myocardial injury (cardiac troponin T ≥14 ng/L)Result — go to the resultOdds ratio 0.65 95% CI 0.23–1.78Authors' 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
Methodological detailsprospective, multicentre, open-label, superiority, observer-blinded endpoints
- Prospective
- Multicentre
- Open-label
- Superiority
- Observer-blinded endpoints
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
| Outcome | Enalapril | Standard care | OR (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 strain | 21.3% | 21.9% | 0.95 (0.33–2.74) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Enalapril | Standard care | Estimate |
|---|---|---|---|
| Absolute LVEF decline >10% to <50% | 4.1% | 0 events |
Original publication
Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma: The PROACT Clinical Trial. JACC CardioOncol. Published 27 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it