Risk-Guided Cardioprotection With Carvedilol in Breast Cancer Patients Treated With Doxorubicin and/or Trastuzumab

Exclusion Criteria

• •Contraindication to carvedilol
• •Baseline systolic blood pressure \< 90mmHg (if multiple blood pressures are available in the medical record within 1 month prior to screening, the average SBP will be considered)
• •Baseline heart rate \< 55 bpm consistent with severe bradycardia (if multiple resting heart rates are available in the medical record within 1 month prior to screening, the average heart rate will be considered)
• •Allergy to carvedilol
• •History of bronchial asthma or related bronchospastic conditions
• •Known history of sick sinus syndrome
• •Severe hepatic impairment, defined as serum bilirubin \> 3.0x ULN, AST or ALT \> 5.0 ULN within 28 days of enrollment
• •Second- or third-degree AV block, as determined by electrocardiogram
• •Severe bradycardia (unless permanent pacemaker is in place)
• •Patients in cardiogenic shock or decompensated heart failure requiring the use of IV inotropic therapy
• •Current use of: Bupropion (Wellbutrin), Fluoxetine (Prozac), Paroxetine (Paxil), Quinidine (Quinidex), Duloxetine (Cymbalta), Digoxin
• •Current treatment with beta blocker
• •Unable to provide consent