Statins May Prevent Heart Damage Caused by Breast Cancer Therapy

Statins, widely used to lower cholesterol and prevent heart disease, may guard against heart damage caused by certain breast cancer therapies, according to a recent study by the American College of Cardiology.

Chemotherapies with anthracycline, as well as the targeted cancer medicine trastuzumab, are commonly used to treat breast cancer. Previous research shows that nearly 1 out of 4 women with early stage breast cancer will receive anthracycline or trastuzumab. However, these therapies are known to be toxic to the heart and, in some cases, can trigger heart failure.

There has been limited evidence supporting the safety and efficacy of large-scale use of cardioprotective medications for patients with early stage breast cancer. Angiotensin antagonists and beta blockers have only shown modest cardioprotective effects in clinical trials, and these medicines are sometimes poorly tolerated in this population. The results of the study 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 1 of these cancer therapies.

Compared with women who were not on a statin before undergoing cancer treatment, women who were taking statins while receiving anthracyclines or trastuzumab had significantly lower risk of developing heart failure, according to the study.

The population-based study analyzed the medical records of 2545 women who were treated with anthracycline and 1345 women treated with trastuzumab, all of whom were aged 66 years or older without a history of heart failure and were diagnosed with early stage breast cancer between 2007 and 2017 in Ontario, Canada. Of these patients, 953 who were treated with anthracycline and 568 who were treated with trastuzumab were found to be taking statins.

Statin use was based on whether women were prescribed a statin within a year of starting their cancer treatment. For their analysis, researchers then matched these women to a 1:1 ratio with similar women who were not using a statin, resulting in 723 pairs of anthracycline-treated women and 399 pairs of trastuzumab-treated women.

The research team examined clinically overt heart failure, defined as a woman presenting to the emergency department or being admitted to the hospital with heart failure. The risk of heart failure-related hospital visits was significantly lower with statin exposure.

The findings provide further need for future prospective trials to determine whether initiating a statin before receiving anthracycline-based chemotherapy or trastuzumab can effectively prevent cardiotoxic events.

Reference

• Statins May Protect Against the Heart Harms of Breast Cancer Therapies [news release]. American College of Cardiology website. Published March 19, 2020. https://www.acc.org/latest-in-cardiology/articles/2020/03/18/15/42/statins-may-protect-against-the-heart-harms-of-breast-cancer-therapies-acc-2020. Accessed March 20, 2020.