/4 Take-home:
ARNI did not significantly preserve LVEF%, but prevented GLS decline and blunted biomarker evidence of chronic myocardial injury/stress.
👉 Suggests potential role in CTRCD prevention. Larger, outcome-driven RCTs needed. #OriginalResearch #CardioOnc #HF

/3 Findings (18 mo):
- Primary endpoint (CMR LVEF%): Placebo –2.2% vs ARNI –1.1%;Δ+1.1%(NS, p=0.16)
-Secondary endpoints:
- GLS: preserved with ARNI, declined with placebo
- Biomarkers: attenuated rise in troponin I & NT-proBNP with ARNI
- Safety: well tolerated, no excess SAEs

/2 Context:
- Anthracyclines & trastuzumab improve breast cancer outcomes but risk CTRCD.
- Prior RCTs of ACEi/ARBs have shown limited benefit in preserving LV function.
- Sacubitril/valsartan (ARNI) improves outcomes in HFrEF → can it prevent CTRCD during adjuvant therapy?

#ESC #SimPub on PRADA II Trial: Can sacubitril/valsartan prevent anthracycline ± trastuzumab–related cardiotoxicity in early breast cancer? 138 women randomized, ARNI vs placebo, followed 18 months with CMR, echo GLS, troponins, NT-proBNP.

🧵Thread summarizing key findings: