Introduction
Cardiovascular diseases, breast cancer, cancer, dementia, Alzheimer’s disease, cardiotoxicity
CANCER, TYPE 2 DIABETES MELLITUS, CARDIOVASCULAR DISEASE, BREAST CANCER
Cardiovascular diseases and cancer are among the primary causes of global mortality. Advances in cancer treatment have increased cancer patients' survival rates. However, a significant number of patients develop cardiotoxicity related to cancer treatment, and this condition is associated with a poor prognosisMetformin is an anti-diabetic agent which has long been use in the treatment of type 2 diabetes mellitus. Evidence from in vitro studies and animal models indicated that metformin could protect against doxorubicin-induced cardiotoxicityDonepezil, an acetylcholinesterase inhibitor, is used primarily in the treatment of dementia and Alzheimer’s disease. Interestingly, an observational study showed that patients treated with donepezil had a lower risk of cardiovascular mortalityTo date, there is no clinical study investigating the role of metformin or donepezil in the prevention of doxorubicin-induced cardiotoxicity. We hypothesized that administration of metformin or donepezil prior to treatment of doxorubicin prevents doxorubicin-induced cardiotoxicity in breast cancer patients.