Prophylactic Agents for Preventing Cardiotoxicity Induced Following Anticancer Agents: A Systematic Review and Meta-Analysis of Clinical Trials.

BACKGROUND: Anthracyclines can improve survival in many types of malignancies, but dose-dependent and irreversible results following the use of anthracyclines have been associated with cardiomyopathy. This meta-analysis aimed to compare the effects of prophylactic agents for preventing cardiotoxicity induced following anticancer agents. METHODS: In this meta-analysis, Scopus, Web of Science, and PubMed were surfed for articles published by December 30th, 2020. The keywords were angiotensin-converting enzyme inhibitor (ACEI), enalapril, captopril, angiotensin receptor blocker, beta blocker, metoprolol, bisoprolol, isoprolol, statin, valsartan, losartan, eplerenone, idarubicin, nebivolol, dihydromyricetin, ampelopsin, spironolactone, dexrazoxane, antioxidants, cardiotoxicity, n-acetyl-tryptamine, cancer, neoplasms, chemotherapy, anthracyclines, doxorubicin, daunorubicin, epirubicin, idarubicin, ejection fraction or a combination of them in the titles or abstracts. RESULTS: A total of 17 articles out of 728 studies examining 2,674 patients were included in this systematic review and meta-analysis. Ejection fraction (EF) values in the baseline, 6-month, and 12-month follow-up in the intervention group turned out to be 62.52 ± 2.48, 59.63 ± 4.85, and 59.42 ± 4.53, whereas in the control group appeared to be 62.81 ± 2.58, 57.69 ± 4.32, and 58.60 ± 4.58, respectively. Through comparison of the two groups, EF was found to increase in the intervention group by 0.40 after 6 months (Standardized mean difference (SMD): 0.40, 95% confidence interval (CI): 0.27, 0.54), thus proving higher than that of the control groups following the cardiac drugs. CONCLUSION: This meta-analysis showed that prophylactic treatment with cardio-protective drugs, including dexrazoxane, beta blocker, and ACEI drugs in patients undergoing chemotherapy with anthracycline, have a protective effect on LVEF and prevent EF drop.

The incidence of congenital hypothyroidism and its determinants from 2012 to 2014 in Shadegan, Iran: a case-control study.

OBJECTIVES: Congenital hypothyroidism (CH) is one of the major causes of preventable mental retardation in infants. The aim of this study was to determine the incidence of CH in Shadegan, Khuzestan Province, Iran from 2012 to 2014 and to identify the risk factors associated with CH. METHODS: A total of 203 cases were confirmed from 2012 to 2014 in Shadegan, with 66, 86, and 51 patients reported in 2012, 2013, and 2014, respectively. A total of 3,900, 3,991, and 4,050 live births occurred in 2012, 2013, and 2014, respectively. The controls (n=657) were selected using a random number table, and a case-control study was carried out to determine the risk factors for neonatal CH, including demographic, environmental, and medical factors. RESULTS: The incidence of CH was 17.0 per 1,000 live births in 2012, 21.5 per 1,000 live births in 2013, and 12.6 per 1,000 live births in 2014. This study showed that the likelihood of CH in children born to parents with a history of consanguineous marriage was 2.41 times greater than in children born to parents with no such history (odds ratio, 2.41; 95% confidence interval [CI], 1.65 to 3.53). This study also found that CH was 3.4 times more likely (95% CI, 2.29 to 5.20) in infants born in urban settings than in infants born in rural areas. CONCLUSIONS: The incidence of CH in Shadegan from 2012 to 2014 was approximately 17 times greater than the expected incidence in Iran. CH was associated with a history of consanguineous marriage and urbanization.