ACC.24 — We are joined onsite by Dr David Austin (South Tees Hospitals NHS Foundation Trust, UK) to discuss the findings from the PROACT trial (NCT03265574).

Anthracyclines used in the treatment of breast cancer cause damage to the muscle cells in the heart, resulting in cardiotoxicity.

PROACT is a phase III randomised superiority trial of enalapril for the prevention of anthracycline-induced cardiotoxicity in patients treated for breast cancer and lymphoma. Patients due to receive anthracycline chemotherapy (epirubicin dose >300mg/m2) at four different centers in the UK were invited to participate in the study, resulting in an enrollment of 170 participants. Received chemotherapy dose was 328mg/m2 doxorubicin-equivalent. 

Findings showed that enalapril did not affect myocardial injury or cardiac function outcomes. 81% of patients had myocardial injury on cardiac troponin T criteria, and 46% of patients had myocardial injury on cardiac troponin I criteria. 21% had a >15% relative decrease in left ventricular global longitudinal strain, and 2% had a >10% reduction in left ventricular ejection fraction to <50%.

Interview Questions: 

1. What is the importance of this study?
2. What was the study design and patient population?
3. What are the key findings revealed at ACC?
4. What are the implications of these findings on clinical practice?
5. What are the knowledge gaps?
6. What are the next steps?

Recorded onsite at the ACC Conference in Atlanta, 2024.

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Support: This is an independent interview conducted by Radcliffe Cardiology.

Editors: Jordan Rance, Mirjam Boros

Video Specialists: Dan Brent, Tom Green, Mike Knight