Statins confer cardioprotection following anthracycline-based chemo for breast cancer
In older women with early breast cancer, using statins after completing a chemotherapy containing anthracyclines appears to reduce the risk of hospitalizations for heart failure (HF), as reported in a study.
The analysis included a propensity-matched cohort of anthracycline‐treated patients who were exposed (n=666) and not exposed (n=666) to statins, as well as trastuzumab-treated patients with (n=390) or without (n=390) exposure to statins, with a median age of 69 and 71 years, respectively.
In the anthracycline cohort, 309 women (46.4 percent) used rosuvastatin, 272 (40.8 percent) used atorvastatin, 51 (7.7 percent) used simvastatin, and 27 (4.1 percent) used pravastatin. In the trastuzumab cohort, 182 women (46.7 percent) used rosuvastatin, 161 (41.3 percent) used atorvastatin, and 31 (8.0 percent) used simvastatin.
The 5‐year cumulative incidence of HF hospital presentations after anthracyclines was markedly lower in the statin-exposed than in the nonexposed group (1.2 percent, 95 percent confidence interval [CI], 0.5–2.6 vs 2.9 percent, 95 percent CI, 1.7–4.6; p=0.01). Statins reduced the risk of hospitalization for HF by more than half (hazard ratio [HR], 0.45, 95 percent CI, 0.24–0.85; p=0.01).
After trastuzumab, on the other hand, the 5‐year cumulative incidence of HF hospital presentations was only slightly lower among statin users than nonusers (2.7 percent, 95 percent CI, 1.2–5.2 vs 3.7 percent, 95 percent CI, 2.0–6.2; p=0.09). The cause‐specific HR of 0.46 (95 percent CI, 0.20–1.07) associated with statins did not reach significance (p=0.07).
The present data support the development of randomized controlled trials of statins for protection against cardiotoxicity.