Statins may protect the heart from chemotherapy treatment for early breast cancer – sciencedaily

“Two types of anti-cancer drugs, anthracyclines and trastuzumab, are effective treatments for many women with breast cancer, but the risk of damage to the heart muscle has limited their use, especially in women with breast cancer. higher risk of heart problems due to their age or other medical problems, ”said Husam Abdel-Qadir, MD, Ph.D., lead author of the study, assistant professor of medicine at the Institute of Policy, Health Management and Assessment at the University of Toronto; and Cardiologist at Women’s College Hospital and the Peter Munk Cardiac Center, which is part of the University Health Network in Toronto.

“The mechanisms behind these drugs are essential for killing breast cancer cells, but these processes can also damage heart muscle cells, leading to weakening of the heart,” he said.

Small previous studies have suggested that women taking statins may have less damage to the heart muscle from these types of chemotherapy. The exact mechanisms for protecting statins from damage to heart cells remain unknown. Statins are believed to have antioxidant and anti-inflammatory actions.

For the present study, researchers used several administrative health databases in Ontario, Canada, to examine the occurrence of heart failure in women aged 66 and older who received anthracyclines or trastuzumab for a Newly diagnosed early stage breast cancer between 2007 and 2017. Every woman already taking statins was matched with a peer who was not taking statins as well as various medical and social factors. The two groups were compared to understand the number of hospitalizations needed or an emergency room visit for heart failure within five years of chemotherapy. None had previously been diagnosed with heart failure.

The researchers found:

In the 666 pairs of women (median age 69) treated with anthracyclines, those taking statins were 55% less likely to be treated in hospital for heart failure (1.2% vs. 2.9%). Among the 390 pairs of women (median age 71) treated with trastuzumab, those taking statins were 54% less likely to be treated in hospital for heart failure (2.7% versus 3.7%), a trend which did not reach statistical significance. “Our results support the idea that statins may be a potential intervention to prevent heart failure in patients receiving chemotherapy with anthracyclines and potentially trastuzumab,” Abdel-Qadir said.

This observational study found an association, but cannot conclude that there is a cause and effect relationship between taking statins and a lower risk of heart failure.

“This study does not conclusively prove that statins are protective,” Abdel-Qadir said. “However, this study builds on the body of evidence suggesting that they may have benefits. For women with breast cancer who meet the established indications for taking a statin, they should ideally continue to take it. throughout their chemotherapy treatment Women who have no indication for a statin should ask their health care team if they can participate in a clinical trial studying the benefits of statins in protecting against injury heart muscle during chemotherapy. Otherwise, they should focus on measures to optimize their cardiovascular health before, during and after chemotherapy. “

The results of this study in older women may not be generalizable to younger women or those at low cardiovascular risk who do not respond to current indications for a statin. Since the populations are demographically similar, these results from Canada are likely generalizable to women in the United States. Other limitations include the fact that the study is a retrospective analysis that relied on administrative data, and the researchers could not take into account potentially important factors that were not available, including the pumping capacity of the pump. heart and cardiac biomarkers.

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