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ACE Inhibitor Not Protective Against Heart Damage from Chemotherapy

DAIC

The PROACT study reported no impact on cardiotoxicity biomarkers or secondary endpoints related to heart function among patients who took high doses of enalapril, an ACE inhibitor, along with high doses of anthracyclines. The mean dose of enalapril among those who were randomized to take the ACE inhibitor was 17.7mg.

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A man in his 70s with chest pain during a bike ride

Dr. Smith's ECG Blog

The patient stated he had a long history of well-controlled hypertension for which he was compliant with his ACE-inhibitor. His initial cTnI at the receiving hospital was 27 ng/mL, and no further troponins were measured thereafter. He was also treated for erectile dysfunction but had not taken any medications recently.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

Another ECG was recorded 5 minutes later just before arrival at the hospital: Similar The patient was transported to a nearby suburban hospital with PCI capabilities while my partner cared for her. Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls.

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