{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T21:20:12Z","timestamp":1790544012801,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,7,15]],"date-time":"2018-07-15T00:00:00Z","timestamp":1531612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Several measures including drugs have been tried to reduce anthracycline cardiotoxicity. The lack of randomized trials prompted this study to assess the role of an angiotensin converting enzyme (ACE) inhibitor (enalapril) in anthracycline\u2010induced cardiotoxicity in children with hematological malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized, double\u2010blind, placebo\u2010controlled trial was conducted on 84 patients with leukemia (41) and lymphoma (43) who received anthracyclines (doxorubicin and\/or daunorubicin) at cumulative dose \u2265200\u00a0mg\/m<jats:sup>2<\/jats:sup>. The patients were randomized to receive either enalapril [group A (<jats:italic>n<\/jats:italic>\u00a0=\u00a044)] or placebo [group B (<jats:italic>n<\/jats:italic>\u00a0=\u00a040)] for 6\u00a0months. Left ventricular ejection fraction (LVEF) and cardiac biomarkers (cardiac troponin I [cTnI], probrain natriuretic peptide [proBNP], and creatine kinase MB [CK\u2010MB]) were assessed at baseline and 6\u00a0months. The primary outcome was a measured decrease in LVEF (\u226520%). Secondary outcome measures were changes in cardiac biomarkers and the development of heart failure or arrhythmias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LVEF decreased in both groups at 6\u00a0months, more so in group B (62.25\u00a0\u00b1\u00a05.49\u00a0vs 56.15\u00a0\u00b1\u00a04.79, P\u00a0&lt;\u00a00.001). A \u226520% decrease was seen in 3 patients in group B but none in group A (P\u00a0=\u00a00.21). Cardiac biomarkers increased more in group B at 6\u00a0months, and the increase was significant for proBNP (49.60\u00a0\u00b1\u00a035.97\u00a0vs 98.60\u00a0\u00b1\u00a054.24, P\u00a0&lt;\u00a00.001) and cTnI (0.01\u00a0\u00b1\u00a00.00\u00a0vs 0.011\u00a0\u00b1\u00a00.003, P\u00a0=\u00a00.035) but not significant for CK\u2010MB (1.08\u00a0\u00b1\u00a00.18\u00a0vs 1.21\u00a0\u00b1\u00a00.44, P\u00a0=\u00a00.079). In group A, 9.1% of the patients showed an increase in proBNP level \u2265100 compared with 37.5% in group B (P\u00a0&lt;\u00a00.001). No patient developed heart failure or arrhythmia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Enalapril has a role in reducing cardiac toxicity after anthracycline administration.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27308","type":"journal-article","created":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T05:16:52Z","timestamp":1531718212000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Role of ACE inhibitors in anthracycline\u2010induced cardiotoxicity: A randomized, double\u2010blind, placebo\u2010controlled trial"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3598-7533","authenticated-orcid":false,"given":"Vineeta","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Pediatrics Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Kumar Singh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tej","family":"Bali Singh","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Department of Community Medicine Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2014.09.017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70042-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70042-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.6.7.1023"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.635144"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360238"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-015-1753-z"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.19253"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4606"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21341"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2006.04.020"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-015-0603-y"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2014.10.013"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/513219"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-9966-31-86"},{"key":"e_1_2_7_17_1","first-page":"589","article-title":"Use of cardiac markers for monitoring of doxorubicin\u2010induced cardiotoxicity in children with cancer","volume":"34","author":"Pongprot Y","year":"2012","journal-title":"J PediatrHematol Oncol"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950240604"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21165"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2217\/fca.12.44"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12012-016-9365-z"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.12.102"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1407-6"},{"key":"e_1_2_7_24_1","first-page":"CD008011","article-title":"Medical interventions for treating anthracycline\u2010induced symptomatic and asymptomatic cardiotoxicity during and after treatment for childhood cancer","volume":"9","author":"Sieswerda E","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_25_1","first-page":"CD008011","article-title":"Medical interventions for treating anthracycline\u2010induced symptomatic and asymptomatic cardiotoxicity during and after treatment for childhood cancer","volume":"8","author":"Cheuk DK","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_26_1","unstructured":"GuptaV SinghSK AgrawalV SinghTB Role of ACE inhibitors in anthracycline induced cardiotoxicity: a randomized double\u2010blind placebo\u2010controlled trial. 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