The Role of Dapagliflozin in Reducing Anthracycline-Induced Cardiotoxicity in Type 2 Diabetes Mellitus Patients with Breast Cancer

Document Type : Original Article

Authors

1 Cardiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

2 Oncology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

3 Diabetology Unit - Internal Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Abstract

Background: Although anthracyclines are a mainstay of treatment for breast cancer, they can cause serious cardiotoxicity, especially in patients who already have other medical problems including type 2 diabetic mellitus (T2DM).  A sodium-glucose cotransporter-2 (SGLT2) inhibitor called dapagliflozin has demonstrated possible cardioprotective benefits. This study examines whether dapagliflozin can help T2DM patients with breast cancer postpone the development of anthracycline-induced cardiotoxicity. Methods: A total of 112 newly diagnosed breast cancer patients with T2DM were recruited and divided into two groups: the Dapagliflozin Group (n=61), which received dapagliflozin 10 mg in addition to standard antidiabetic therapy, and the Control Group (n=49), which received only standard antidiabetic therapy. Echocardiographic parameters (ejection fraction [EF], global longitudinal strain [GLS]) and biomarkers of cardiotoxicity (troponin I, BNP) were assessed at baseline and follow up at 3 and 6 months. Results: At 3 and 6 months follow up, the Dapagliflozin group showed significantly lower levels of troponin I and BNP, along with better-preserved EF and GLS compared to the control group. The cardioprotective effects of dapagliflozin became more pronounced over time. Receiver Operating Characteristic (ROC) curve analysis demonstrated that dapagliflozin had a strong predictive ability for preventing cardiotoxicity. Conclusion: Dapagliflozin showed significant cardioprotective effects in T2DM patients receiving anthracycline-based chemotherapy, suggesting its potential role in reducing anthracycline-induced cardiotoxicity. Further randomized controlled trials are necessary to confirm the cardioprotective benefits of SGLT2 inhibitors in this patient population.

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