Effect of carvedilol on echocardiographic fraction shortening, troponin I, malondialdehyde in trastuzumab treated females with breast cancer

Background: Trastuzumab therapy is effective in HER2 positive breast cancer patients, but it is highly complicated by cardiotoxicity.Objective: To elucidate the possible effects of carvedilol on echocardiographic fraction shortening, serum troponin I and serum malondialdehyde in trastuzumab treated females with HER2 positive breast cancer.Patients and Methods: A total of twenty six females with HER2 positive breast cancer were enrolled in this study. The patients were randomized into two groups, thirteen patients in each group. Group I included patients who received trastuzumab therapy for 8 cycles with 21 days apart. Group II included patients who treated with trastuzumab therapy with carvedilol 3.125 mg, orally, twice daily dose for 8 cycles. Echocardiography was used to measure fraction shortening at zero time, 4th and 8th cycles in both groups. Serum troponin I and malondialdehyde were measured at zero time, 2nd, 4th, 6th and 8th cycles in both groups. Results: Treatment with trastuzumab therapy caused a significant decrement in echocardiographic fraction shortening at an only 8th cycle in comparison to baseline readings (P 0.05).Combined trastuzumab plus carvedilol caused a significant increase in echocardiographic fraction shortening compared with that of trastuzumab therapy group (P 0.05). Regarding serum troponin I and malondialdehyde, trastuzumab therapy caused a significant increment in both these markers in comparison to baseline readings (P 0.05). Combined trastuzumab plus carvedilol caused significant decrement in troponin I and malondialdehyde compared with that of trastuzumab therapy group (P 0.05).Conclusion: Carvedilol causes significant increment in echocardiographic fraction shortening and significant decrement in serum troponin I and malondialdehyde in trastuzumab treated patients.