Sodium-glucose Transporter Type 2 Inhibition in Anthracycline-related Cardiotoxicity

Inclusion Criteria

• •Patients with breast cancer between 18-70 years of age.
• •Patients with low to medium cardiovascular risk.
• •Patients scheduled for adjuvant or neo-adjuvant anthracycline therapy.
• •Patients who are able to give written informed consent to take part in the study.
• •Patients who can read and understand English.
• •The current thresholds for defining cardiovascular risk for patients undergoing anthracycline chemotherapy are as follows: normal resting 12-lead electrocardiogram, plasma cardiac troponin I concentration \< 99th centile, serum brain natriuretic peptide concentration \<35 pg/mL or serum N-terminal pro-brain natriuretic peptide concentration \<125 pg/mL, left ventricular ejection fraction \>55%, global longitudinal strain \>-18% and healthy life-style (normal body-mass index, non-smoker). Low cardiovascular risk will allow for the presence of one abnormal life-style factor (body-mass index indicating obesity (\>30 kg/m2), current smoker or significant smoking history), or presence of only one of the following in the clinical history: hypertension, stage 1-2 chronic kidney disease, age 65-79 years, borderline left ventricular ejection fraction (50-54%) or elevated cardiac biomarkers. Medium cardiovascular risk will permit the combination of any 2-4 of the lifestyle or clinical history variables indicated above.