Evidence map›Paper›PMID 36672461›Full record

ReviewCancers2023

Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis.

Ainsley Ryan Yan Bin Lee, Chun En Yau, Chen Ee Low, Jiaqi Li, Sara Moiz Tyebally, Weiqin Lin, Li-Ling Tan, Chia-Te Liao, Wei-Ting Chang, Matilda Xinwei Lee and 2 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
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  4. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ainsley Ryan Yan Bin LeeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Chun En YauYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.ORCID 0000-0002-5844-8962
Chen Ee LowYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Jiaqi LiSchool of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK.
Sara Moiz TyeballyDivision of Cardiology, Ng Teng Fong General Hospital, Singapore 609606, Singapore.
Weiqin LinYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.ORCID 0000-0001-8319-504X
Li-Ling TanYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Chia-Te LiaoDivision of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan.
Wei-Ting ChangDivision of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan.
Matilda Xinwei LeeDepartment of Haematology-Oncology, National University Cancer Institute, Singapore 117597, Singapore.
Chieh-Yang KooDivision of Cardiology, Ng Teng Fong General Hospital, Singapore 609606, Singapore.ORCID 0000-0002-6051-3807
Ching-Hui SiaYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.ORCID 0000-0002-2764-2869

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnthracyclines form the backbone of many systemic chemotherapy regimens but are accompanied by dose-limiting cardiotoxicity. We elucidate the progression and severity of cardiac function over time, in the absence of cardioprotection, which less is known about.

methodsThis PRISMA-guideline-adherent review was registered on PROSPERO (CRD42022373496).

results26 studies met the eligibility criteria including a total of 910 patients. The overall reduction in post-anthracycline pooled mean left ventricular ejection fraction (LVEF) in placebo arms of the included randomised-controlled trials was 4.5% (95% CI, 2.6 to 6.4). The trend in LVEF showed a progressive decline until approximately 180 days, after which there was no significant change. Those receiving a cumulative anthracycline dose of 300 mg/m2 experienced a more profound reduction. The overall pooled risk of a 10% absolute decline in LVEF from baseline, or a decline to an LVEF below 50%, was 17% (95% CI: 11 to 24; I2 = 71%). Sensitivity analyses of baseline LVEF and trastuzumab treatment status did not yield significant differences.

conclusionWhile the mean LVEF decline in patients without cardioprotective therapy was clinically small, a vulnerable subset experienced significant impairment. Further research to best identify those who benefit most from cardioprotective therapies when receiving anthracyclines is required.

Indexed as

anthracyclinesbreast cancercardio-oncologycardiotoxicitychemotherapy toxicityhaematological cancerheart failure

Identifiers

PMID36672461
PMCPMC9856944

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Registered trials

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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.