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Background: Even prolonged cancer-related survival in patients (pts) treated with anthracyclines is reported, the treatment related cardiotoxicity is still a major concern. To the best of our knowledge, there are no published data on this issue. The aim of this study was to assess the effect of uninterrupted therapy with trimetazidine (UTT) on new-onset left ventricular systolic dysfunction (LVD) +/- overt heart failure (HF) in pts with breast cancer (BC) treated with epirubicin (E).
Methods: We analysed retrospectively the decade 01/01/2006-31/12/2015 with 216 adult pts newly diagnosed with biopsy confirmed BC who underwent anthracycline based chemotherapy with E standard doses. The study group had 72 pts and received UTT for usual indications. Their counterparts did not receive UTT. The date of the cancer confirmatory diagnosis was considered the study enter date. Demographycally: mean age of pts was 50,8 +/-10,9 yrs., female gender predominance 99,3%. The primary outcome was incident HF hospitalisation, and the follow-up period 5,37 +/- 2,65 yrs.
Results: After propensity matching (1:2) the 72 pts receiving UTT were combined with 144 controls. New onset symptomatic HF was diagnosed in 23 pts, 12 within the study group (28,6% IV NYHA class) and 18 in their counterparts (30,8% IV NYHA class). New onset LVD was found in 91 pts, 40 within the UTT group (7,83% with LVEF < 40%) and 51 in comparator group (9,61% with LVEF < 40%). The proportions in the 2 groups were 4,8612 and 9,0278, and the dispersion 0.046258, and 0.082137, respectively. Due to poor representation of men we could not afford to look for any significant statistical outcomes between genders.
Conclusions: In our study, trimetazidine co-medication was associated with lower risk for incident HF in pts with BC treated with E. This finding warrants for further prospective investigation. Since the mechanism of anthracycline cardiotoxicity seems to be related with oxygen free radicals, the metabolic effects of trimetazidine may mitigate cardiotoxicity.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Is Just a Revolving Door
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1293-250
- 2017 American College of Cardiology Foundation