Enalapril más Carvedilol en la prevención de la cardiotoxicidad por antraciclinas y/o trastuzumab

Introduction: Chemotherapy cardiotoxicity affects quality of life and survival in cancer patients. Objective: To evaluate the effectiveness of enalapril plus carvedilol in the prevention of cardiotoxicity in patients with cancer treated with anthracyclines and / or trastuzumab. Method: A descriptive, longitudinal prospective study was carried out in 66 cancer patients who received treatment with anthracyclines and / or trastuzumab at the Hermanos Ameijeiras Hospital between June and October 2017, which were divided into two groups according to enalapril preventive use plus carvedilol (n = 31) or placebo (n = 35). Results: The frequency of cardiotoxicity was higher in patients who received anthracyclines plus trastuzumab compared to those who received only anthracyclines (27.8% versus 12.5%, p = 0.1538, respectively). The percentage of patients with anthracycline doses greater than 400 mg / m2 (72.7% vs. 20.0%, p = 0.0008) and mediastinal radiotherapy (36.3% vs. 8.1%, p = 0 , 0407) were higher in those who developed cardiotoxicity. The involvement of diastolic function (p = 0.0113) and the decrease in ejection fraction (p = 0.0375) were lower in patients who received preventive treatment with enalapril plus carvedilol. Conclusions: Cardiotoxicity is more likely to appear if trastuzumab and mediastinal radiotherapy are added to oncospecific treatment. Preventive treatment with enalapril plus carvedilol in breast cancer patients receiving anthracyclines and / or trastuzumab decreases the probability of cardiotoxicity. Introducción: La Cardiotoxicidad por quimioterapia afecta calidad de vida y supervivencia en pacientes con cáncer. Objetivo: Evaluar la efectividad del enalapril más carvedilol en la prevención de cardiotoxicidad en pacientes con cáncer con tratamiento de antraciclinas y/o trastuzumab. Método: Se realizó estudio descriptivo, longitudinal prospectivo en 66 pacientes con cáncer que recibieron tratamiento con antraciclinas y/o trastuzumab en el Hospital Hermanos Ameijeiras entre junio y octubre del 2017, los que fueron divididos en dos grupos según empleo preventivo de enalapril más carvedilol (n=31) o placebo (n=35). Resultados: La frecuencia de cardiotoxicidad fue mayor en pacientes que recibieron antraciclinas más trastuzumab respecto a los que recibieron solo antraciclinas (27,8% frente a 12,5%, p=0,1538, respectivamente). El porcentaje de pacientes con dosis de antraciclinas mayores de 400 mg/m2 (72,7% frente a 20,0%, p=0,0008) y radioterapia