ArticleJACC. CardioOncology2019
Efficacy of Neurohormonal Therapies in Preventing Cardiotoxicity in Patients with Cancer Undergoing Chemotherapy.
Article in JACC. CardioOncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
81 citing papers in PubMed, 5 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- Pooled it
- Risk prediction models for cancer therapy related cardiac dysfunction in patients with cancer and cancer survivors: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Renin-angiotensin System Antagonists and Beta-blockers in Prevention of Anthracycline Cardiotoxicity: a Systematic Review and Meta-analysis.Arquivos brasileiros de cardiologia · 2023Pooled it
- Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis.Cancer causes & control : CCC · 2021Pooled it
- Cardioprotective effects of exercise training on doxorubicin-induced cardiomyopathy: a systematic review with meta-analysis of preclinical studies.Scientific reports · 2021Pooled it
- Biomarker-Guided Cardioprotection for Patients Treated With Anthracyclines: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Randomized, Placebo-Controlled, Triple-Blind Clinical Trial of Ivabradine for the Prevention of Cardiac Dysfunction During Anthracycline-Based Cancer Therapy.Journal of the American Heart Association · 2025Trial
- Strain surveillance during chemotherapy to improve cardiovascular outcomes: the SUCCOUR-MRI trial.European heart journal · 2024Trial
- Statins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines.European heart journal. Cardiovascular pharmacotherapy · 2023Trial
- Cardiac safety of dual anti-HER2 blockade with pertuzumab plus trastuzumab in early HER2-positive breast cancer in the APHINITY trial.ESMO open · 2023Trial
- Risk-guided cardioprotection in cardio-oncology.Nature cardiovascular research · 2026Review
- Sacubitril/Valsartan for Prevention of Cancer Therapy-Related Cardiac Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of cardiovascular development and disease · 2026Review
- From Cardioprotection to Trial Design: Rethinking Cardiac Safety in Oncology.Current heart failure reports · 2026Review
- Review
- Clinical utility of the HFA-ICOS risk tool in real-world HER2-positive breast cancer patients receiving therapy.Cardio-oncology (London, England) · 2026Article
- Sacubitril/valsartan for the prevention of cancer therapy-related cardiac dysfunction: a systematic review and meta-analysis.Cardio-oncology (London, England) · 2026Article
- Review on cardioprotective strategies in the setting of chemotherapy-induced cardiotoxicity.Cardio-oncology (London, England) · 2026Review
- Evolving Cardioprotective Strategies in Cardio-Oncology: A Narrative Review.Current cardiology reports · 2025Review
- SGLT2i Dapagliflozin in primary prevention of chemotherapy induced cardiotoxicity in breast cancer patients treated with neo-adjuvant anthracycline-based chemotherapy +/- trastuzumab: rationale and design of the multicenter PROTECT trial.Cardio-oncology (London, England) · 2025Article
- Cardiotoxicity in Elderly Breast Cancer Patients.Cancers · 2025Review
21 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundVarious cardioprotective approaches have been evaluated to prevent chemotherapy-related cardiotoxicity; however, their overall utility remains uncertain.
objectivesTo assess the effects of neurohormonal therapies in preventing cardiotoxicity in patients receiving chemotherapy.
methodsThis meta-analysis included randomized clinical trials of adult patients that underwent chemotherapy and neurohormonal therapies (beta-blockers, mineralocorticoid receptor antagonists, or ACE inhibitors/ARBs) vs. placebo with follow-up ≥4 weeks. The primary outcome was change in left ventricular ejection fraction (LVEF) from baseline to the end of trial. Other outcomes of interest were measures of LV size, strain, and diastolic function. Pooled estimates for each outcome were reported as standardized mean difference (SMD) and weighted mean difference (WMD) between the neurohormonal therapy and placebo groups using random effects models.
resultsWe included 17 trials, collectively enrolling 1,984 participants. In pooled analysis, neurohormonal therapy (vs. placebo) was associated with significantly higher LVEF on follow-up [SMD(95% CI): +1.04(0.57 to 1.50)] but with significant heterogeneity in the pooled estimate (I
conclusionsNeurohormonal therapies are associated with higher LVEF in follow-up among cancer patients receiving chemotherapy, although absolute changes in LVEF are small and may be within inter-test variability. Furthermore, significant heterogeneity is observed in the treatment effects across studies highlighting the need for larger trials of cardioprotective strategies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.