Protective effects of nebivolol against anthracycline-induced cardiomyopathy: A randomized control study

Background: We aimed to evaluate the effect of prophylactic nebivolol use on prevention of antracycline-induced cardiotoxicity in breast cancer patients. Methods: In this small, prospective, double-blind study, we randomly assigned 45 consecutive patients with breast cancer and planned chemotheraphy to receive nebivolol 5 mg daily (n=27) or placebo (n=18). Echocardiographic measurements and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels were obtained at baseline and at 6-month of chemotherapy. Results: Both studied groups had comparable echocardiographic variables and NT-pro-BNP levels at baseline. At 6-month, the left ventricular (LV) end-systolic and end-diastolic diameters increased in the placebo group (LVESD: 29.7 +/- 3.4 to 33.4 +/- 4.5 mm; LVEDD: 47.2 +/- 3.8 to 52.0 +/- 4.6 mm, p=0.01 for both) but remained unchanged in the nebivolol group (LVESD: 30.4 +/- 3.5 to 31.0 +/- 3.6 mm, p=0.20; LVEDD: 47.0 +/- 4.4 to 47.1 +/- 4.0 mm, p=0.93). The placebo group also had lower LVEF than the nebivolol group (57.5 +/- 5.6% vs. 63.8 +/- 3.9%, p=0.01) at 6-month. NT-pro-BNP level remained static in the nebivolol group (147 +/- 57 to 152 +/- 69 pmol/l, p=0.77) while it increased in the placebo group (144 +/- 66 to 204 +/- 73 pmol/l, p=0.01). Conclusions: Prophylactic use of nebivolol treatment may protect the myocardium against antracycline-induced cardiotoxicity in breast cancer patients. (C) 2012 Elsevier Ireland Ltd. All rights reserved.