Potential role of angiotensin-converting enzyme inhibitors vs beta-blockers in preventing anticancer agents-induced cardiotoxicity: A systematic review and meta-analysis

doi:10.4330/wjc.120930

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World Journal of Cardiology

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1949-8462

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Cardiol. Jun 26, 2026; 18(6): 120930
Published online Jun 26, 2026. doi: 10.4330/wjc.120930

Potential role of angiotensin-converting enzyme inhibitors vs beta-blockers in preventing anticancer agents-induced cardiotoxicity: A systematic review and meta-analysis

Rohab Sohail, Ridda Khattak, Haider Hussain Shah, Zaraq Khan, Azeem Khan, Shahryar Chaudhry, Simran Patel, Rohan Patel, Vyom Patel, Madihah Alam, Samar Mehdi, Manjeet Singh

Rohab Sohail, Ridda Khattak, Azeem Khan, Shahryar Chaudhry, Simran Patel, Rohan Patel, Madihah Alam, Samar Mehdi, Department of Internal Medicine, Bayhealth Medical Center, Dover, DE 19904, United States

Haider Hussain Shah, Department of Medicine, Bayhealth Hospital, Kent Campus, Dover, DE 19901, United States

Zaraq Khan, Department of Internal Medicine, Indiana University School of Medicine, Southwest Internal Medicine Residency Program, Evansville, IN 46202, United States

Vyom Patel, Department of Internal Medicine, Indiana University School of Medicine, Evansville, IN 47591, United States

Manjeet Singh, Department of Cardiology and Cardiovascular Diseases, Bayhealth Medical Center, Dover, DE 19904, United States

Author contributions: Sohail R, Khattak R, Hussain Shah H, Khan Z, Khan A, Chaudhry S, Patel S, Patel R, Patel V, Alam M, and Mehdi S worked on writing-original draft; Sohail R conceptualized the study, designed the methodology, performed formal analysis and software operation, and prepared the original manuscript draft; Sohail R Khattak R, and Shah H validated the research concept; Sohail R and Singh M reviewed and edited the manuscript; Shah H undertook project administration; Singh M supervised the overall study; and all authors reviewed and approved the final submitted version.

AI contribution statement: ChatGPT was used for language polishing, translation, and writing assistance of the manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Rohab Sohail, MD, Department of Internal Medicine, Bayhealth Medical Center, 640 South State Street, Dover, DE 19904, United States. rohabsohail98@gmail.com

Received: March 12, 2026
Revised: April 13, 2026
Accepted: June 2, 2026
Published online: June 26, 2026
Processing time: 99 Days and 9.9 Hours

Core Tip

Core Tip: This meta-analysis compared angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers for the prevention of anti-cancer agents-induced cardiotoxicity. Across randomized controlled trials, both drug classes showed similar effectiveness in preserving left ventricular ejection fraction and preventing overall, early, and late cardiotoxicity. Overall adverse event rates were similar between groups; however, hypotension and dizziness occurred more frequently with ACEI therapy. These findings suggest that ACEI and beta-blockers provide comparable cardioprotective benefit. Choice of therapy should therefore be individualized based on patient characteristics, blood pressure profile, and tolerability. Larger, adequately powered trials with longer follow-up are needed to determine whether meaningful differences between these strategies emerge over time.