PCSK9 Inhibitors and Anthracyclines: The Future of Cardioprotection in Cardio-Oncology.

Autor: Repp ML; Department of Medicine, University of Colorado, Aurora, CO 80045, USA., Edwards MD; Department of Medicine, University of Michigan, Ann Arbor, MI 48109, USA., Burch CS; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA., Rao A; Department of Medicine, Banner University Medicine, Tucson, AZ 85724, USA., Chinyere IR; Department of Medicine, Banner University Medicine, Tucson, AZ 85724, USA.; Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Room 6154, Tucson, AZ 85724, USA.
Jazyk: angličtina
Zdroj: Hearts (Basel, Switzerland) [Hearts (Basel)] 2024 Sep; Vol. 5 (3), pp. 375-388. Date of Electronic Publication: 2024 Sep 03.
DOI: 10.3390/hearts5030027
Abstrakt: The field of cardio-oncology is an expanding frontier within cardiovascular medicine, and the need for evidence-based guidelines is apparent. One of the emerging focuses within cardio-oncology is the concomitant use of medications for cardioprotection in the setting of chemotherapy regimens that have known cardiovascular toxicity. While clinical trials focusing on cardioprotection during chemotherapy are sparse, an inaugural trial exploring the prophylactic potential of Sodium-Glucose Cotransporter-2 inhibitors (SGLT2is) for anthracycline (ANT)-induced cardiotoxicity has recently commenced. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, though less studied in this oncology demographic, have exhibited promise in preclinical studies for conferring cardiac protection during non-ischemic toxic insults. While primarily used to reduce low-density lipoprotein, PCSK9 inhibitors exhibit pleiotropic effects, including the attenuation of inflammation, reactive oxygen species, and endothelial dysfunction. In ANT-induced cardiotoxicity, these same processes are accelerated, resulting in premature termination of treatment, chronic cardiovascular sequelae, heart failure, and/or death. This review serves a dual purpose: firstly, to provide a concise overview of the mechanisms implicated in ANT-induced cardiotoxicity, and, finally, to summarize the existing preclinical data supporting the theoretical possibility of the cardioprotective effects of PCSK9 inhibition in ANT-induced cardiotoxicity.
Competing Interests: Conflicts of Interest: The authors declare no relevant conflicts of interest.
Databáze: MEDLINE
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