Added-on trimetazidine continuous therapy could lower the risk of incidental left ventricular dysfunction +/-overt heart failure in liposomal epirubicinum recipients for breast or ovarian cancer

Introducere: Despite prolonged cancer-related survi-val in patients treated with anthracyclines is reported, the cardiotoxicity related to treatment is still a major concern. The energo-metabolic agent trimetazidine has strong evidences in ischemic heart disease.
Objective: The goal of this study was to assess the effect of trimetazidine continuous therapy (TCT) on new-on-set left ventricular dysfunction (LVD) +/- overt heart failure (HF) in female patients (fp) with breast cancer (BC) or ovarian cancer (OC) treated with liposomal epirubicinum (LE). To the best of our knowledge, there is no data published on this issue.
Methods: We analysed retrospectively from JAN/2008 a number of 576 adult fp newly diagnosed with biopsy confirmed BC or OC who underwent chemotherapy with LE standard doses. The study group had 144 patients, 72 with BC and 72 with OC, and received TCT for usual indications. Their counterparts did not receive TCT (432 female patients, 216 with OC and 216 with BC). The date of the cancer confirmatory diagnosis was considered the study enter date. Demographically: mean age of pts was 51.3 +/-10.8 yrs.; obviously, male patients with BC were not included. The primary out-come was incident HF hospitalisation, and the follow-up period 6.79 +/- 2.94 yrs.
Results: After propensity matching (1:2) the 144 fp receiving TCT were combined with 432 controls. New onset symptomatic HF was diagnosed in 52 female pati-ents, 21 within the study group (28.6% IV NYHA class) and 31 in their counterparts (30.8% IV NYHA class). New onset LVD was found in 182 female patients, 79 within the TCT group (7.83% with LVEF <40%) and 103 in control (9.61% with LVEF <40%). The distribu-tion of cardiovascular co-morbidities was quite similar in all groups.
Conclusions: According to outcomes, TCT was asso-ciated with lower risk for incident LVD +/- HF in pa-tients with BC or OC treated with LE. However, furt-her prospective investigation is desirable. Taking into account that the mechanism of anthracycline cardioto-xicity could be related to oxygen free radicals, we could assume that energometabolic effects of trimetazidine may alleviate cardiotoxicity. In addition, the quite si-milar results for the two cancer locations suggests that feminine hormonarium could become a common de-nominator.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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