ArticleJACC. CardioOncology2024
Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma: The PROACT Clinical Trial.
Article in JACC. CardioOncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03265574 (Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma), which is not on this map. Cited by 27 papers.
What it found
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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.
Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma: a Phase 3 Randomised, Open Label, Blinded Endpoint, Superiority Trial of Enalapril to Prevent Anthracycline-induced CardioToxicity
Who cites it
27 citing papers in PubMed.
- Biomarker-Guided Cardioprotection for Patients Treated With Anthracyclines: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Sacubitril/Valsartan and Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy: The PRADA II Randomized Clinical Trial.Circulation · 2025Trial
- Risk-guided cardioprotection with carvedilol in patients with breast cancer (CCT guide): a phase 1 randomized clinical trial.Breast cancer research and treatment · 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
- Risk-guided cardioprotection in cardio-oncology.Nature cardiovascular research · 2026Review
- Ventricular Arterial Coupling as a Marker of Early Cardiotoxicity in Survivors of Childhood Cancer.Pediatric cardiology · 2026Article
- Cardiac remodelling and dysfunction in cancer patients receiving cardiotoxic therapies: proteomic and metabolomic profiling.European heart journal · 2026Article
- 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
- Exploring the Mechanisms of Total Saponins of Black Ginseng and Ginsenoside Rg3 Against Doxorubicin-Induced Cardiotoxicity.Food science & nutrition · 2026Article
- Article
- Cardio-oncology research prioritisation in the United Kingdom: national surveys of health care professionals, patients and carers.Cardio-oncology (London, England) · 2026Article
- Cardioprotective strategies of ACEi/ARBs and beta-blockers against anthracycline-induced cardiotoxicity in pediatric cancer survivors: a systematic review.Cardio-oncology (London, England) · 2026Review
- Understanding the distinct role of PI3K(p110Frontiers in cardiovascular medicine · 2026Review
- Pharmacological prevention in cardio-oncology: from bench-to-bedside.Heart failure reviews · 2025Review
- Chemotherapy-induced cardiotoxicity in breast cancer: mechanisms, diagnostic advances, and emerging protective strategies.American journal of physiology. Heart and circulatory physiology · 2025Review
- Effectiveness of a Smartphone-Based Self-Management App (BeHealth app) for Women with Breast Cancer: A Randomized Controlled Trial.Iranian journal of public health · 2025Article
- Evolving Cardioprotective Strategies in Cardio-Oncology: A Narrative Review.Current cardiology reports · 2025Review
- Prefectural Survey on Anthracycline-Related Cardiomyopathy at the Start of the Basic Plan to Promote Cancer Control Programs - Phase 4.Circulation reports · 2025Article
- Cardio-Oncology Considerations for Breast Cancer: Risk Stratification, Monitoring, and Treatment.Oncology (Williston Park, N.Y.) · 2025Review
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
Background: Cardiotoxicity is a concern for cancer survivors undergoing anthracycline chemotherapy. Enalapril has been explored for its potential to mitigate cardiotoxicity in cancer patients. The dose-dependent cardiotoxicity effects of anthracyclines can be detected early through the biomarker cardiac troponin. Objectives: The PROACT (Preventing Cardiac Damage in Patients Treated for Breast Cancer and Lymphoma) clinical trial assessed the effectiveness of enalapril in preventing cardiotoxicity, manifesting as myocardial injury and cardiac function impairment, in patients undergoing high-dose anthracycline-based chemotherapy for breast cancer or non-Hodgkin lymphoma. Methods: This prospective, multicenter, open-label, randomized controlled trial employed a superiority design with observer-blinded endpoints. A total of 111 participants, scheduled for 6 cycles of chemotherapy with a planned dose of ≥300 mg/m Results: Myocardial injury, indicated by cardiac troponin T (≥14 ng/L), during and 1 month after chemotherapy, was observed in 42 (77.8%) of 54 patients in the enalapril group vs 45 (83.3%) of 54 patients in the standard care group (OR: 0.65; 95% CI: 0.23-1.78). Injury detected by cardiac troponin I (>26.2 ng/L) occurred in 25 (47.2%) of 53 patients on enalapril compared with 24 (45.3%) of 53 in standard care (OR: 1.10; 95% CI: 0.50-2.38). A relative decline of more than 15% from baseline in left ventricular global longitudinal strain was observed in 10 (21.3%) of 47 patients on enalapril and 9 (21.9%) of 41 in standard care (OR: 0.95; 95% CI: 0.33-2.74). An absolute decline of >10% to <50% in left ventricular ejection fraction was seen in 2 (4.1%) of 49 patients on enalapril vs none in patients in standard care. Conclusions: Adding enalapril to standard care during chemotherapy did not prevent cardiotoxicity in patients receiving high-dose anthracycline-based chemotherapy. (PROACT: Can we prevent Chemotherapy-related Heart Damage in Patients With Breast Cancer and Lymphoma?; NCT03265574).
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