Cholesterol-lowering drugs may protect a woman’s heart from damage caused by chemotherapy

Statins, common cholesterol-lowering drugs, could protect women’s hearts from damage done during chemotherapy for early-stage breast cancer, according to a new study published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

“Two types of cancer medication, anthracyclines and trastuzumab, are effective treatments for many women with breast cancer, however, the risk of heart muscle damage is limited, especially in women who are pregnant. higher risk for heart problems due to age or other medical issues, “said Husam Abdel-Qadir, MD, Ph.D., lead author of the study, associate professor of medicine at the University of Toronto ‘s Institute of Health Policy, Management and Evaluation, and cardiologist at Women’s College Hospital and Peter Munk Cardiac Center, part of the University Health Network in Toronto.

“The techniques for these medications are essential to kill breast cancer cells, however, these processes can also damage the heart muscle cells, leading to the weakening of the heart,” he said.

Previous small studies have suggested that women who take statins may experience less heart muscle damage from these types of chemotherapy. It is not yet known what the exact mechanisms are by how statins protect against card cell damage. Statins are believed to have antioxidant and anti-inflammatory activities.

For the current study, researchers used several administration health databases in Ontario, Canada, to review heart failure in women age 66 and older who received anthracyclines or trastuzumab for advanced-stage breast cancer. tested between 2007 and 2017. All women already had statins matched by peers who did not take statins in addition to several medical and social background factors. The two groups were compared to understand how many needed hospitalization or an emergency room visit for heart failure within the five years after chemotherapy. None have been previously diagnosed with heart failure.

Searched by researchers:

• Of the 666 pairs of women (middle age 69) treated with anthracyclines, those taking statins were 55% more likely to be hospitalized for heart failure (1.2% vs. 2.9%) .
• In the 390 pairs of women (middle-aged 71) treated with trastuzumab, those taking statins were 54% less likely to be hospitalized for heart failure (2.7% vs. 3.7%) , a movement that did not reach statistical significance.

“Our findings support the notion that statins may be a potential intervention to prevent heart failure in patients receiving chemotherapy with anthracyclines and trastuzumab, “Abdel-Qadir said.

This speculative 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 immune. However, this study builds on the body of evidence suggesting that they may have benefits. For women with breast cancer who meet established symptoms for taking a statin, they should continue to take it through their chemotherapy treatment. Women who do not have a sign for statin should ask their healthcare team if they can join a clinical trial examining the benefits of statins in protecting against heart muscle damage during chemotherapy. Furthermore, they should focus on measures to achieve optimal cardiovascular health before, during and after chemotherapy. “

Abdel-Qadir, MD, Ph.D., Lead Author, Associate Professor, Medicine, University of Toronto, Cardiologist, Women’s College Hospital, Peter Munk Cardiac Center

The findings of this study in older women may not be universally applicable to younger women or to those at low cardiovascular risk who do not meet normal indications for statin. Given the similarities in demographics, these results from Canada appear to be similar for women in the United States. Other limitations include that the study is a retrospective analysis that relied on administrative data, and the researchers were unable to describe factors that may have influenced it. important not available, including heart pumping capacity and heart biomarkers.