New research from UHN’s Peter Munk Cardiac Center (PMCC) shows that statins, which are commonly prescribed to lower cholesterol and the risk of heart disease and stroke, may protect the heart from the harmful effects of early breast cancer treatment.
Published January 6, 2021 in the Journal of the American Heart Association, a speculative study found that women who were already taking statins and treated with anthracyclines or trastuzumab were half as likely to be hospitalized or visit an Emergency Department for heart failure within five years after chemotherapy.
Our job is to protect the heart and ensure it has the greatest chance of fighting through chemotherapy. “
Dr. Husam Abdel-Qadir, Lead Author, Cardiologist, PMCC, Women’s College Hospital
He notes that preliminary observational studies of heart strength measures have been reported in women with statin treatment after chemotherapy, but focus on only one center. “Our study focused on women across Ontario. We went beyond just a number indicating a weaker heart – we focused on heart failure hard enough for women to come to an Emergency Department or be hospitalized.”
Anthracyclines and trastuzumab are effective treatments for many women with breast cancer. However, the increased risk of cardiotoxicity is limited in use, and damage can be severe enough to cause heart failure.
Using several health databases in Ontario, researchers reviewed heart failure in women age 66 and older who received trastuzumab or anthracyclines for early breast cancer diagnosed between 2007 and 2017.
Of the 666 pairs of women treated with anthracyclines, those taking statins were 55 percent less likely to be hospitalized for heart failure. In the 390 pairs of women treated with trastuzumab, those taking statins were 54 percent less likely, who suggested a protective move but did not meet statistical significance.
Oxidative stress is believed to be one of the mechanisms by which cancer treatment leads to damage to the heart muscle. It is defined as an imbalance of free radicals, fertilizers that can harm your body if levels are too high, and antioxidants, molecules that fight free radicals.
In addition to lowering cholesterol, statins can also protect the body against the effects of oxidative stress. If statins can stop this imbalance, they could reduce the likelihood of heart damage as a result of cancer treatment.
“To determine if there is a true cause-and-effect relationship, we need to conduct a proper randomized controlled trial,” says Dr. Abdel-Qadir, who is also part of the Ted Rogers Center for Research’s Cardiotoxicity Prevention Program for Research Heart (TRCHR).
“At the moment, if a woman has the right to start treatment for breast cancer and already has an established symptom of being on a statin, there is now an added incentive to start or stay on it.”
As for the next steps, Dr. Dinesh Thavendiranathan, a cardiologist at PMCC, director of the TRCHR Cardiotoxicity Prevention Program and senior author of the study is currently recruiting for a SPARE-HF randomized controlled trial, which will assess its have been pretreated with statins before. anthracycline-chemotherapy can prevent cardiotoxicity in high-risk patients.
“It’s part of the bigger principles we try to apply within the TRCHR Cardiotoxicity Program, which is you really shouldn’t change the cancer treatment, let the oncologist know the best treatment selected for the patient, ”said Dr. Abdel-Qadir.
“We try to reduce the risks that come with it. Our vision is that patients should be able to get the best cancer treatment and at the same time reduce worries for the heart. . “
Source:
University Health Network
Magazine Reference:
Abdel – Qadir, H., et al. (2021) Statin Exposure and Risk of Heart Failure after Anthracycline‐ or Trastuzumab-Based Chemistry for Early Breast Cancer: Appropriate Score of Equivalent Cohort Study. Journal of the American Heart Association. doi.org/10.1161/JAHA.119.018393.