New research from the Journal of the American Heart Association found that statins, common cholesterol-lowering medications, may protect women’s hearts from damage caused during chemotherapy for early-stage breast cancer.

“Two types of cancer medications, anthracyclines and trastuzumab, are effective treatments for many women with breast cancer, however, the risk of heart muscle damage has limited their use, particularly in women who are at higher risk for heart problems because of their age or other medical issues,” said lead study author Husam Abdel-Qadir, MD, PhD, in a press release.

According to the study authors, previous small studies suggested that women taking statins may have less heart muscle damage from these types of chemotherapy, yet the exact mechanisms of how statins protect against the cardiac cell damage remains unknown. It is also believed that statins have antioxidative and anti-inflammatory actions.

In the current study, researchers used several administrative health databases in Ontario, Canada, to review the occurrence of heart failure in women 66 years of age and older who received anthracyclines or trastuzumab for newly diagnosed early-stage breast cancer between 2007 and 2017.

Each woman already taking statins was matched with a peer who was not taking statins, as well as a variety of medical and social background factors. Further, the 2 groups were compared to understand how many required hospitalizations or emergency department visits occurred for heart failure within the 5 years after chemotherapy. None had previously been diagnosed with heart failure, according to the study authors.

The researchers found that in the 666 pairs of women treated with anthracyclines, those taking statins were 55% less likely to be treated at the hospital for heart failure. In the 390 pairs of women treated with trastuzumab, those taking statins were 54% less likely to be treated at the hospital for heart failure, a trend that did not reach statistical significance.

“Our findings support the idea that statins may be a potential intervention for preventing heart failure in patients receiving chemotherapy with anthracyclines and potentially trastuzumab,” Abdel-Qadir said in a press release.

Although the study found an association, the study authors noted that they 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 statins are protective,” Abdel-Qadir said in a press release. “However, this study builds on the body of evidence suggesting that they may have benefits. For women with breast cancer who meet established indications for taking a statin, they should ideally continue taking it throughout their chemotherapy treatment. Women who do not have an indication for a statin should ask their health care team if they can join a clinical trial studying the benefits of statins in protecting against heart muscle damage during chemotherapy. Otherwise, they should focus on measures to optimize their cardiovascular health before, during and after chemotherapy.”

The findings from this study in older women may not be generalizable to younger women or to those at low cardiovascular risk who do not meet current indications for a statin, according to the study authors. A limitation to the study is that the results coming from Canada are likely generalizable to women in the United States.

Other limitations include that the study is a retrospective analysis that relied on administrative data, and the researchers could not account for potentially important factors that were not available, including the heart’s pumping ability and heart biomarkers.

REFERENCE
Statins may protect the heart from chemotherapy treatment of early breast cancer. American Heart Association. https://newsroom.heart.org/news/statins-may-protect-the-heart-from-chemotherapy-treatment-of-early-breast-cancer#:~:text=DALLAS%2C%20Jan.%206%2C%202021,of%20the%20American%20Heart%20Association. Published January 6, 2021. Accessed January 8, 2021.