title: Protective effects of spironolactone against anthracycline-induced cardiomyopathy.
abstract: OBJECTIVE
  The protective effect of beta-blockers, ACE inhibitors, and ARBs on anthracycline cardiotoxicity has already been demonstrated, but the effect of aldosterone antagonism, which inhibits the last step of the renin-angiotensin-aldosterone system (RAAS), was questioned. This study sought to investigate whether spironolactone protects the heart against anthracycline-induced cardiotoxicity.
  
  
  RESULTS
  Eighty-three female patients who were diagnosed with breast cancer were included in the study. The study population was randomized into spironolactone and control groups. A dose of 25 mg/day spironolactone was administered to the patients in the spironolactone group. There were 43 patients (mean age 50 ± 11 years) in the spironolactone group and 40 patients (mean age 51 ± 10 years) in the control group. LVEF decreased from 67.0 ± 6.1 to 65.7 ± 7.4 (P = 0.094) in the spironolactone group, and from 67.7 ± 6.3 to 53.6 ± 6.8 in the control group (P < 0.001). When the general linear model was applied, the interaction of LVEF decrease between groups was significantly lower in the spironolactone group than in the control group (P < 0.001). The diastolic functional grade of subjects in the spironolactone group was protected (P = 0.096), whereas it deteriorated in the control group (P < 0.001).
  
  
  CONCLUSIONS
  We showed that spironolactone administration used simultaneously with anthracycline group chemotherapeutics protects both myocardial systolic and diastolic functions. Spironolactone can be used to protect against anthracycline-induced cardiotoxicity.
  
  
  BACKGROUND
  NCT02053974.
authors.affiliation: Erciyes University, Department of Cardiology, Kayseri, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozdogru
authors.forename: Omer
authors.initials: O
authors.lastname: Sahin
authors.forename: Mevlude
authors.initials: M
authors.lastname: Inanc
authors.forename: Ali
authors.initials: A
authors.lastname: Dogan
authors.forename: Cevat
authors.initials: C
authors.lastname: Yazici
authors.forename: Veli
authors.initials: V
authors.lastname: Berk
authors.forename: Halit
authors.initials: H
authors.lastname: Karaca
authors.forename: Nihat
authors.initials: N
authors.lastname: Kalay
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Oguzhan
authors.forename: Ali
authors.initials: A
authors.lastname: Ergin
mesh_terms: D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000517:prevention & control*; D004311:Double-Blind Method; D004317:Doxorubicin / Q000009:adverse effects; D004452:Echocardiography; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D013148:Spironolactone / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D015251:Epirubicin; D004317:Doxorubicin
keywords: Anthracycline; Cardiomyopathy; Spironolactone