BACKGROUND The effects of β blockers on the primary prevention of anthracycline-induced cardiotoxicity were controversial. METHODS We searched PubMed, Embase and Cochrane Library for randomized controlled trials of the comparison of β blockers versus placebo in patients undergoing anthracycline chemotherapy. This meta-analysis was performed by using random-effect models. RESULTS Nine hundred forty participants from 11 trials were included in this meta-analysis. β blockers led to a significant reduction in symptomatic heart failure (risk ratio [RR] 0.29, 95% CI 0.10 to 0.85). Compared with placebo, β blockers were associated with improved left ventricular ejection fraction (mean difference [MD] 4.46, 95% CI 1.77 to 7.15) and s' (MD 0.78, 95% CI 0.01 to 1.55) in parallel with reduced left ventricular diameter (left ventricular end systolic diameter, MD -3.19, 95% CI -6.17 to - 0.21; left ventricular end diastolic diameter, MD -2.28, 95% CI 4.50 to - 0.05). β blockers also improved strain and strain rate when compared with placebo. There were no significant differences in diastolic function variables between β blockers and placebo except e' (MD 2.33, 95% CI 0.16 to 4.51). In addition, β blockers compared with placebo reduced the risk of cardiac troponin I elevation > 0.04 ng/ml (RR 0.60, 95% CI 0.42 to 0.85). There was no marked difference in adverse events (RR 0.94, 95% CI 0.56 to 1.59) between β blockers and placebo. CONCLUSIONS In cancer patients with anthracycline therapy, prophylactic β blockers were associated with reduced risk of heart failure, decreased left ventricular diameter, improved left ventricular systolic function, and alleviative cardiomyocyte injury.

中文翻译：

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Beta受体阻滞剂对蒽环类药物引起的心脏毒性的一级预防：一项随机对照试验的荟萃分析。

背景β受体阻滞剂对蒽环类药物引起的心脏毒性的一级预防的作用尚存争议。方法我们在PubMed，Embase和Cochrane库中搜索了接受蒽环类药物化疗的患者中β受体阻滞剂与安慰剂比较的随机对照试验。这项荟萃分析是通过使用随机效应模型进行的。结果这项荟萃分析包括来自11个试验的940位参与者。β受体阻滞剂可显着减少症状性心力衰竭（风险比[RR] 0.29，95％CI 0.10至0.85）。与安慰剂相比，β受体阻滞剂与左心室射血分数改善（平均差[MD] 4.46，95％CI 1.77至7.15）和s'（MD 0.78，95％CI 0.01至1）相关。55）与减小的左心室直径平行（左心室收缩末期直径，MD -3.19，95％CI -6.17至-0.21;左心室舒张末期直径，MD -2.28，95％CI 4.50至-0.05）。与安慰剂相比，β受体阻滞剂还改善了应变和应变率。除e'外，β受体阻滞剂和安慰剂之间的舒张功能变量无显着差异（MD 2.33，95％CI 0.16至4.51）。此外，与安慰剂相比，β受体阻滞剂降低了心肌肌钙蛋白I升高> 0.04 ng / ml的风险（RR 0.60，95％CI 0.42至0.85）。β受体阻滞剂与安慰剂之间的不良事件无显着差异（RR 0.94，95％CI 0.56至1.59）。结论在接受蒽环类药物治疗的癌症患者中，预防性β受体阻滞剂可降低心力衰竭风险，降低左心室直径，