Relationship between changes in left ventricular ejection and use of angiotensin-converting enzyme inhibitors and/or betablockers during adjuvant trastuzumab chemotherapy in early breast cancer: Data from the real world.

645 Background: Adjuvant trastuzumab chemotherapy (aTrastC) improves DFS of pts with breast cancer and overexpression of HER-2. However, cardiovascular complication (CV) such as heart failure (HF) or significant left ventricular ejection fraction (LVEF) reduction may appear especially in those pts at increased CV risk. Methods: 253 women treated with aTrastC for EBC in 7 italian oncologic centers during the period 2008-2009 entered in a multicenter registry and were retrospectively studied in 4 subgroups according to the treatment with ACEi and/or BB. Occurrence of symptoms of HF and/or decrease in 10 points % of LVEF were recorded during the follow up. LVEF was measured at baseline and 3-6-9-12 months. Results: Symptoms of HF occurred in 2% of pts who did not take either ACEi/ARB or BB. HF event-rate was similarly increased in pts receiving one or both medications, partially justified by the increased CV risk in these subgroups. Prevalence of decrease in LVEF > 10 points% was similar in all study subgrou...