Statins Could Reduce Cardiotoxicity, Heart Failure from Chemotherapy

While chemotherapy with anthracycline and trastuzumab have been linked to cardiotoxicity, new research is suggesting a common cardiovascular medication could help offset some of the negative impact on cardiovascular health in breast cancer patients.

Analysis of nearly 4000 women presented at American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC) revealed early-stage breast cancer patients receiving anthracyclines or trastuzumab who were also taking statins cut their risk of heart failure (HF) by more than half.

“Our results suggest that taking statins is associated with a significantly lower risk of developing heart failure requiring hospital-based care among women with early-stage breast cancer who received one of these cancer therapies,” said study presenter David Bobrowski, MS3, a medical student at the University of Toronto, in a statement.

With research indicating almost 25% of women with early-stage breast cancer receive anthracycline or trastuzumab, Bobrowski and a team from Women’s College Hospital in Toronto sought to evaluate whether the reduction of oxidative stress and production of free radicals in heart cells associated with statin use could attenuate the risk of cardiotoxicity. To evaluate the potential benefits of statins in this population, investigators designed a population-based, retrospective cohort study of women 66 years of age and older diagnosed with early-stage breast cancer in Ontario from 2007-2017.

For the purpose of the study, use of statins was defined as having a prescription dispensed in the year prior to chemotherapy. Study participants were propensity-matched with untreated women in both cohorts. The primary outcome of interest was risk of hospitalization or emergency department visits for HF.

In total, 2545 anthracycline-treated women and 1345 trastuzumab-treated women were identified. Of these, 953 receiving anthracycline and 568 receiving trastuzumab were also taking statins. Ultimately, investigators created 723 statin-discordant pairs of anthracycline-treated women and 399 statin-discordant pairs of trastuzumab-treated women for inclusion in their analysis.

Over a median follow-up period of 5 years, results indicated statin use was associated with a significantly lower risk of HF compared to those who did not receive statins. Specifically, patients in the trastuzumab-treated group experienced a 66% reduction and patients in the anthracycline-treated group experienced a 58% reduction in risk of HF.

“Declines in left ventricle function can be predictive of heart failure, but overt heart failure gives a more clear-cut outcome that carries more relevance to cancer patients and their physicians,” Bobrowski said, in the aforementioned statement. “The findings provide impetus for future prospective trials to determine whether initiating a statin before receiving anthracycline-based chemotherapy or trastuzumab can effectively prevent cardiotoxic events.”

This study, “Statins Are Associated With Lower Risk of Heart Failure After Anthracycline And Trastuzumab Chemotherapy For Early Stage Breast Cancer,” was presented at ACC.20/WCC.