Table 2.

A summary of the most important clinical trials in primary prevention of cardiotoxicity.16,40–47 LVEF: left ventricular ejection fraction

STUDY	PATIENTS	CHEMOTHERAPY REGIMEN	CARDIOPROTECTIVE DRUG	PRIMARY OUTCOME	FOLLOW-UP (MONTHS)
Cardinale44 2006	114	Epirubicin	Enalapril	Cardiotoxicity incidence:	12
		Idarubicin		Control: 43%
		Daunorubicin		Enalapril: 0%
				P < .001
Kalay40 2006	50	Doxorubicin	Carvedilol	LVEF change pre/post chemotherapy:	6
		Epirubicin		Placebo: 68.9%/52.3%; P < .001
				Carvedilol: 70.5%/69.7%; P = .30
Georgakopoulos45 2010	125	Doxorubicin	Metoprolol	No difference in cardiotoxicity	12
			Enalapril	P = .55
Bosch46 2013	201	Idarubicin	Carvedilol	Mean change in LVEF reduction (%):	6
		Daunorubicin	Enalapril	Control: −3.28
				Enalapril + Carvedilol: −0.17%
				P = .04
Kaya41 2013	45	Doxorubicin	Nebivolol	LVEF change pre/post chemotherapy:	6
		Epirubicin		Placebo: 66.6%/57.5%; P = .001
				Nebivolol: 65.6%/63.8%; P = .50
Gulati42 2016	126	Epirubicin	Metoprolol	Mean change in LVEF reduction (%):	6
			Candesartan	Placebo: −2.6
				Candesartan: 0.8; P = .026
				Metoprolol: −1.6%; P = .77
Pituskin16 2017	94	Trastuzumab	Bisoprolol	Mean change in LVEF reduction (%):	12
			Perindopril	Placebo: 5%
				Perindopril: 3%
				Bisoprolol: −1 %
				P = .01
Avila43 2018	200	Doxorubicin	Carvedilol	No change in LVEF	6
				P = .84
Guglin47 2019	468	Trastuzumab	Lisinopril	Cardiotoxicity rate:	12
			Carvedilol	Placebo: 32% × lisinopril 30%, carvedilol 29%
				P = .27, P = .35