Exploratory Review of the Role of Statins, Colchicine, and Aspirin for the Prevention of Radiation‐Associated Cardiovascular Disease and Mortality

Planek, Maria Isabel Camara; Silver, A.; Volgman, Annabelle Santos; Okwuosa, Tochukwu

doi:10.1161/jaha.119.014668

Cited by 28 publications

(18 citation statements)

References 67 publications

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“…According to a retrospective study, statin use was associated with a significant reduction in the incidence of stroke of 32% among cancer patients after radiation to the thorax, head and neck ( 44 ). There is growing evidence of anti-inflammatory medication to prevent radiation-associated CVDs, such as statins, colchicine and aspirin ( 45 ). More evidence is necessary for anti-inflammatory medication to prevent radiation-associated CVD.…”

Section: Discussionmentioning

confidence: 99%

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Lin

Cheng²,

Hsu³

et al. 2022

Front. Oncol.

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BackgroundThe relative risk for cerebrovascular disease (CVD) is increased in patients with head and neck cancer (HNC) treated with radiotherapy (RT). However, the current relative risk for CVD following RT has not been well clarified. The purpose of this study was to analyze the effect of RT and update the risk of CVD following RT in HNC patients through a systematic review and meta-analysis.Material and MethodsWe conducted an online database search and systematic review of observational studies that reported on CVD and extracranial carotid stenosis in patients with HNC who had undergone RT. Articles published in Medline and PubMed from 1980 to 2021 were identified and collected.ResultsOf the forty-seven articles identified from PubMed and forty-four articles identified from 3 systematic reviews, twenty-two studies were included. We found that neck RT was a significant risk factor for CVD (HR 3.97, 95% CI: 2.89-5.45). Patients with HNC treated by RT had an increased OR (7.36, 95% CI: 4.13-13.11) for CVD, and approximately 26% (95% CI: 22%-31%) of HNC patients treated with RT were at risk for CVD with more than 50% reduction in carotid diameter.ConclusionThe risk of CVD is increased in patients with HNC treated by RT, and recent improvements in RT techniques may have contributed to the decreased risk of CVD. These results suggest that regular follow-up and appropriate screening for CVD should be required for patients with HNC.

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Section: Discussionmentioning

confidence: 99%

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Lin

Cheng²,

Hsu³

et al. 2022

Front. Oncol.

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“… 23 Compared with other treatment methods, chest radiotherapy, received by patients with Hodgkin’s lymphoma, increases the risk of cardiovascular disease by 2.2 to 3.1 times, and the risk can even be as high as 7.2 times, as shown in a study. 24 …”

Section: Discussionmentioning

confidence: 99%

Puerarin Reduces Radiation-Induced Vascular Endothelial Cell Damage Via miR-34a/Placental Growth Factor

Liu

Zhao

et al. 2022

Dose-Response

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The aim is to explore the protective effects of Puerarin on radiation-induced vascular endothelial cell damage and its underlying mechanism. The apoptosis and DNA damage of Human umbilical vascular endothelial cells (HUVECs) exposed to radiation alone or in combination with glucose in the exposed group were significantly elevated ( P < .05) compared with those in the control group. The Puerarin-treated HUVECs showed significant reduction in the radiation-induced apoptosis and DNA damage ( P < .05). Furthermore, X-ray irradiation significantly increased the expression of miR-34a, which was reversed by pre-treatment with Puerarin. Placental Growth Factor (PLGF) was a target gene of miR-34a. The expression of PLGF in the peripheral blood of patients receiving radiotherapy significantly increased with an increase in the cumulative dose of radiation ( P < .05), after which it began to decrease at the fourth week ( P < .05) and then remained at a low level until the end of radiotherapy. Puerarin exerts a radioprotective effect by decreasing DNA damage and apoptosis through miR-34a-targeted PLGF.

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“…There is a paucity of randomized, controlled trials on the use of cardioprotective medication to prevent radiotherapy-induced myocardial damage in humans, and cardioprotective therapy is not a part of current recommendations. 65 However, preclinical and observational studies have investigated the potential of statins to decrease the risk for radiotherapy-induced cardiovascular disease. 66 , 67 Colchicine, aspirin, and novel therapies targeting inflammatory pathways may attenuate myocardial inflammation and fibrosis, but clinical evidence of the effect during radiotherapy is lacking.…”

Section: Therapy-specific Cardioprotective Strategiesmentioning

confidence: 99%

The Role of Cardioprotection in Cancer Therapy Cardiotoxicity

Omland

Heck

Gulati

2022

JACC: CardioOncology

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Exploratory Review of the Role of Statins, Colchicine, and Aspirin for the Prevention of Radiation‐Associated Cardiovascular Disease and Mortality

Cited by 28 publications

References 67 publications

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Puerarin Reduces Radiation-Induced Vascular Endothelial Cell Damage Via miR-34a/Placental Growth Factor

The Role of Cardioprotection in Cancer Therapy Cardiotoxicity

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