Patients treated with radiotherapy who received statin therapy had a 26% reduced risk of cerebrovascular events (RR 0.74) compared to those who did not.
Do cardioprotective medications (primarily statins) reduce cardiovascular and cerebrovascular events in adult patients treated with radiotherapy to the head, neck, or thorax?
In patients receiving head, neck, or thoracic radiotherapy, statin therapy is associated with a reduced risk of cerebrovascular events but not MACE, though these cardioprotective medications remain significantly underutilized despite guideline indications.
Absolute Event Rate: 0% vs 0%
Abstract Purpose The purpose of this systematic review and meta-analysis is to explore the utilization of cardioprotective medications in patients treated with RT and assess their impact on cardiovascular and cerebrovascular events. Materials/methods A literature search of PubMed, Embase and Scopus was performed in March 2025. Studies of adult patients treated with RT to the head and neck or thoracic regions which investigated the effects of cardioprotective medications (defined as anti-hypertensives, lipid-lowering therapies or anti-thrombotic medications) on the incidence of cardiovascular or cerebrovascular events were eligible for inclusion. Studies that reported the proportion of patients treated with RT who were utilizing cardioprotective medications as recommended by CVD guidelines were also included. Meta-analysis was performed using R with a random effects model. Results There were 10 retrospective studies which were eligible for inclusion. Five of the ten studies included patients with head and neck cancer only, whilst two studies included patients with lung cancer and one study included patients with breast cancer alone. Meta-analysis of three studies suggested that patients treated with RT who received statin therapy had a reduced risk of cerebrovascular events (stroke or transient ischemic attack), with a relative risk of 0.74 (95% CI 0.60-0.90). There was no difference in major adverse cardiac events (MACE) for patients treated with RT to the head and neck or thoracic regions who received statin therapy compared to those who did not (relative risk 0.99, 95% CI 0.67 to 1.46, n = 5 studies). A meta-analysis of four studies suggested that 59% (95% CI 35% to 80%) of patients treated with RT not on statin therapy had indications for commencement of these medications. Conclusion Current evidence exploring the impact of cardioprotective medications on CVD risk in patients treated with RT is heterogenous and limited to retrospective non-randomized studies. A considerable proportion of patients undergoing RT are not being prescribed cardioprotective medications as suggested by existing CVD guidelines.
Pakeerathan et al. (Thu,) reported a other. Patients treated with radiotherapy who received statin therapy had a 26% reduced risk of cerebrovascular events (RR 0.74) compared to those who did not.