{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:45:00Z","timestamp":1770281100221,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"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":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cancer therapy\u2010related cardiac dysfunction (CTRCD) is a complication of selected cancer therapy agents associated with decline in left ventricular ejection fraction (LVEF). Angiotensin\u2010converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have established benefits in heart failure with reduced ejection fraction, but their efficacy for preventing CTRCD remains controversial. This narrative systematic review assessed the efficacy and safety of ACEI\/ARB in the prevention of cancer therapy LVEF decline. We systematically searched PubMed, Embase and Cochrane from January 1980 to June 2022. Studies of interest were randomised controlled trials of patients with normal LVEF and active malignancy receiving cancer therapy, randomised to receive either an ACEI or ARB compared with a control group. The outcome was the change in LVEF from baseline to the end of the follow\u2010up period. Death, clinical heart failure and adverse drug reactions were recorded. A total of 3731 search records were screened and 12 studies were included, comprising a total of 1645 participants. Nine studies assessed the prevention of anthracycline\u2010induced LVEF decline, of which five showed a beneficial effect (1%\u201314% higher LVEF in treated groups), whereas four studies showed no effect. Three studies assessed the prevention of trastuzumab\u2010induced LVEF decline, of which one showed a beneficial effect (4% higher LVEF) in a subset of participants. There are mixed data regarding the efficacy of ACEI\/ARB in preventing the LVEF decline in patients undergoing anthracycline or trastuzumab therapy, with evidence suggesting no clinically meaningful benefit observed in recent studies.<\/jats:p>","DOI":"10.1111\/imj.16437","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T11:56:27Z","timestamp":1718366187000},"page":"1254-1263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevention of anthracycline and trastuzumab\u2010induced decline in left ventricular ejection fraction with angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blocker: a narrative systematic review of randomised controlled trials"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2591-0364","authenticated-orcid":false,"given":"Simon","family":"Lee","sequence":"first","affiliation":[{"name":"Cardiology Department Middlemore Hospital  Auckland New Zealand"},{"name":"Cardiology Department Tauranga Hospital  Tauranga New\u00a0Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ammar","family":"Alsamarrai","sequence":"additional","affiliation":[{"name":"Green Lane Cardiovascular Service Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Xiao","sequence":"additional","affiliation":[{"name":"Cardiology Department Middlemore Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom K. 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