Aging, cardiotoxicity, and chemotherapy

Recently, the Carvedilol Effect in Preventing Chemotherapy-Induced Cardiotoxicity (CECCY) trial showed that carvedilol had a neutral effect on the primary prevention of anthracycline-induced cardiotoxicity evaluated by left ventricular ejection fraction (LVEF) after 6 months of follow-up (absolute reduction of 1.3% in placebo and 0.9% in carvedilol group, p=ns) [1]. However, carvedilol significantly decreased troponin levels and diastolic dysfunction. The impact of reduced troponin levels on long-term follow-up is unknown. Otherwise, troponin proliferation is associated with subclinical cardiac injury, and it is a predictor of cardiac death and the occurrence of heart failure. The CECCY trial is the largest randomized placebo-controlled trial for primary prevention of anthracycline induced-cardiotoxicity that has tested the efficacy of carvedilol. It included 200 breast cancer patients with a low risk of cardiovascular disease who were receiving carvedilol at a cumulative dose of anthracycline of 240 mg/m2