MONICA SAMUEL AVILA GRINBERG
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject RENIN-ANGIOTENSIN SYSTEM AND BETA BLOCKERS IN PREVENTION OF ANTHRACYCLINE CARDIOTOXICITY: A SYSTEMATIC REVIEW AND META-ANALYSIS(2020) AVILA, Monica; SIQUEIRA, Suellen; WALDECK, Lucas; AYUB-FERREIRA, Silvia M.; TAKX, Richard; BITTENCOURT, Marcio; BOCCHI, Edimar AlcidesconferenceObject CARVEDILOL FOR PREVENTION OF CHEMOTHERAPY-INDUCED CARDIOTOXICITY: FINAL RESULTS OF THE PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND, PLACEBO CONTROLLED CECCY TRIAL(2020) AYUB-FERREIRA, Silvia M.; AVILA, Monica; BRANDAO, Sara; CRUZ, Fatima D.; WANDERLEY JR., Mauro; RIGAUD, Vagner O. C.; HAJJAR, Ludhmila; KALIL-FILHO, Roberto; CRUZ, Cecilia B. V.; ALVES, Marco Stephan; GUIMARAES, Guilherme V.; ABDUCH, Maria; ISSA, Victor S.; SANTOS, Marilia; BITTENCOURT, Marcio; BOCCHI, Edimar Alcides- REPLY: Can Carvedilol Prevent Chemotherapy-Related Cardiotoxicity? A Dream to Be Balanced With Tolerability(2018) AVILA, Monica Samuel; FERREIRA, Silvia Moreira Ayub; BOCCHI, Edimar Alcides
- Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity(2018) AVILA, Monica Samuel; AYUB-FERREIRA, Silvia Moreira; WANDERLEY JR., Mauro Rogerio de Barros; CRUZ, Fatima das Dores; BRANDAO, Sara Michelly Goncalves; RIGAUD, Vagner Oliveira Carvalho; HIGUCHI-DOS-SANTOS, Marilia Harumi; HAJJAR, Ludhmila Abrahao; KALIL FILHO, Roberto; HOFF, Paulo Marcelo; SAHADE, Marina; FERRARI, Marcela S. M.; COSTA, Romulo Leopoldo de Paula; MANO, Max Senna; CRUZ, Cecilia Beatriz Bittencourt Viana; ABDUCH, Maria Cristina; ALVES, Marco Stephan Lofrano; GUIMARAES, Guilherme Veiga; ISSA, Victor Sarli; BITTENCOURT, Marcio Sommer; BOCCHI, Edimar AlcidesBACKGROUND Anthracycline (ANT) chemotherapy is associated with cardiotoxicity. Prevention with beta-blockers remains controversial. OBJECTIVES This prospective, randomized, double-blind, placebo-controlled study sought to evaluate the role of carvedilol in preventing ANT cardiotoxicity. METHODS The authors randomized 200 patients with HER2-negative breast cancer tumor status and normal left ventricular ejection fraction (LVEF) referred for ANT (240 mg/m(2)) to receive carvedilol or placebo until chemotherapy completion. The primary endpoint was prevention of a >= 10% reduction in LVEF at 6 months. Secondary outcomes were effects of carvedilol on troponin I, B-type natriuretic peptide, and diastolic dysfunction. RESULTS Primary endpoint occurred in 14 patients (14.5%) in the carvedilol group and 13 patients (13.5%) in the placebo group (p = 1.0). No differences in changes of LVEF or B-type natriuretic peptide were noted between groups. A significant difference existed between groups in troponin I levels over time, with lower levels in the carvedilol group (p = 0.003). Additionally, a lower incidence of diastolic dysfunction was noted in the carvedilol group (p = 0.039). A nonsignificant trend toward a less-pronounced increase in LV end-diastolic diameter during the follow-up was noted in the carvedilol group (44.1 +/- 3.64 mm to 45.2 +/- 3.2 mm vs. 44.9 +/- 3.6 mm to 46.4 +/- 4.0 mm; p = 0.057). CONCLUSIONS In this largest clinical trial of beta-blockers for prevention of cardiotoxicity under contemporary ANT dosage, the authors noted a 13.5% to 14.5% incidence of cardiotoxicity. In this scenario, carvedilol had no impact on the incidence of early onset of LVEF reduction. However, the use of carvedilol resulted in a significant reduction in troponin levels and diastolic dysfunction.(Carvedilol Effect in Preventing Chemotherap-Induced Cardiotoxicity [CECCy] NCTO1724450)(C) 2018 by the American College of Cardiology Foundation.