Key result
Statins reduce anthracycline-induced cardiotoxicity by ~54% compared to control.
Why the study?
The role of statins in preventing anthracycline-induced cancer therapy-related cardiovascular dysfunction (CTRCD) remains unclear.
Does statin therapy prevent echocardiographic decline in adult patients receiving anthracycline-based chemotherapy?
Meta-Analysis (n=887)
Does statin therapy prevent echocardiographic decline in adult patients receiving anthracycline-based chemotherapy?
Relative Risk: 0.46 (95% CI 0.29–0.72)
p-value: p=< 0.001
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Although the available data do not conclusively support the universal use of cardioprotective statin therapy, the current guideline recommendation to consider statins for patients at high or very high risk, such as those receiving high-dose anthracyclines, seems appropriate.”
“There is a clear protective effect of atorvastatin in terms of cardiac dysfunction in patients with lymphoma treated with anthracyclines.”
“We believe that some patients with lymphoma being treated with a certain type of cancer drug called anthracyclines may benefit from the statin therapy.”
In patients receiving anthracycline-based chemotherapy, statin use was associated with preserved early diastolic relaxation but did not significantly attenuate LVEF decline after adjusting for baseline differences.
INTRODUCTION Several interventions have been tested for cardio-protection against anthracycline-induced cancer therapy-related cardiovascular dysfunction (CTRCD). The role of statins in this setting remains unclear. METHODS We systematically searched PubMed, Embase, Cochrane Library, Clinicaltrials.gov, and Web of Science for randomized controlled trials (RCTs) comparing statins versus control (placebo or no intervention) for preventing anthracycline-induced CTRCD. We applied a random-effects model to pool risk ratios (RR) and mean differences (MD) with 95 % confidence intervals (CI). RESULTS We included seven RCTs comprising 887 patients with planned chemotherapy with anthracycline-based regimens, of whom 49.8 % were randomized to statins. Relative to placebo, statins significantly reduced the incidence of cardiotoxicity/CTRCD (RR 0.46; 95 % CI 0.29 to 0.72; p < 0.001). The left ventricular end-systolic volume was also lower in patients treated with statin (MD -3.12 mL; 95 % CI -6.13 to -0.12 mL; p = 0.042). There was no significant difference between groups in post-anthracycline left ventricular ejection fraction (LVEF) overall. CONCLUSION In this meta-analysis of RCTs, statins were significantly associated with a lower incidence of anthracycline-induced CTRCD and attenuated changes in the left ventricular end-systolic volume. Thus, our findings suggest that statins should be considered as a cardio-protection strategy for patients with planned anthracycline-based chemotherapy.
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Felix et al. (2024) conducted a meta-analysis in Anthracycline-induced cancer therapy-related cardiovascular dysfunction (CTRCD) (n=887). Statins vs. Control (placebo or no intervention) was evaluated on Incidence of cardiotoxicity/CTRCD (RR 0.46, 95% CI 0.29 to 0.72, p=< 0.001). Statins significantly reduced the incidence of anthracycline-induced cardiotoxicity/CTRCD compared to control (RR 0.46; 95% CI 0.29 to 0.72; p < 0.001).
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