The efficacy and influencing factors of angiotensin converting enzyme inhibitor/angiotensin Ⅱ receptor blocker drugs in the treatment of cardiovascular toxicity induced by bevacizumab

Wang Juan; Qin Mingqiang; Zhang Hui

doi:10.3760/j.issn.1673-4777.2024.11.007

Abstract：Objective To explore the efficacy and influencing factors of angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)drugs in the treatment of cardiovascular toxicity induced by bevacizumab,so as to provide reference for clinical improvement of anti-cardiovascular toxicity.Methods A total of 128 cancer patients with cardiovascular toxicity after bevacizumab treatment in Jiangsu Second Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were selected.Patients were divided into two groups according to whether they were treated with ACEI/ARB drugs,95 patients who took ACEI/ARB drugs were included in the observation group,and 33 patients who did not take ACEI/ARB drugs were included in the control group.The levels of cardiac troponin Ⅰ(cTnⅠ),N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),systolic blood pressure and diastolic blood pressure were compared between the two groups.Univariate and multivariate analysis were used to analyze the influencing factors of cardiovascular toxicity caused by ACEI/ARB drugs in the treatment of bevacizumab.Results The levels of NT-proBNP,cTnⅠ,systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group,and the LVEF was higher than that in the control group(all P＜0.05).In the clinical effect evaluation of ACEI/ARB drugs in the treatment of cardiovascular toxicity,60 cases(63.2％)were cured,30 cases(31.6％)were improved and 5 cases(5.3％)were ineffective.Clinical staging(odds ratio=5.349),concomitant cardio-vascular disease(odds ratio=3.132),cardiac toxicity grade(odds ratio=4.218),plasma NT-proBNP(odds r atio=2.824),and plasma cTnⅠ(odds ratio=3.779)levels were risk factors for cardiovascular toxicity effects of ACEI/ARB drug therapy,while LVEF level(odds ratio=0.333)was a protective factor for cardiovascular toxicity effects of ACEI/ARB drug therapy(all P＜0.05).Conclusion ACEI/ARB drugs have a certain effect in the treatment of cardiovascular toxicity induced by bevacizumab,which can reduce cardiovascular toxicity and myocardial injury.The risk factors for ACEI/ARB treatment included clinical stage,cardiovascular disease,cardiotoxicity grade,NT-proBNP and cTnⅠ,while LVEF was a protective factor.