HMG-CoA-reductase inhibitor co-therapy lowers the risk for incident heart failure in farmorubicin recipients for two cancer locations

Tase, Adrian; Tetiu, O.; Săvoiu, Gheorghe; Stanciulescu, G; Mihaila, Marius

doi:10.1093/eurheartj/eht307.141

Cited by 4 publications

(9 citation statements)

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“…1. A total of six studies were included in the meta-analysis, including four observational cohort studies with a total of 813 patients [19][20][21][22] and two RCTs with a total of 117 patients [23,24].…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

“…One study specifically excluded patients with prior heart failure [22]. In all cohort studies, patients receiving statins had a higher prevalence of cardiovascular risk factors or established coronary artery disease [20,22,23] The primary outcome, cardiotoxicity, was examined in three cohort studies [19,20,22] and two RCTs [23,24]. Two cohort studies [19,21] and two RCTs [23,24] also examined the secondary outcome, mean change in LV ejection fraction.…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

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Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis

Obasi

Abovich

et al. 2021

Cancer Causes Control

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Purpose Cardiotoxicity affects 5–16% of cancer patients who receive anthracyclines and/or trastuzumab. Limited research has examined interventions to mitigate cardiotoxicity. We examined the role of statins in mitigating cardiotoxicity by performing a systematic review and meta-analysis of published studies. Methods A literature search was conducted using PubMed, Embase, Web of Science, ClinicalTrials.gov, and Cochrane Central. A random-effect model was used to assess summary relative risks (RR), weighted mean differences (WMD), and corresponding 95% confidence intervals. Testing for heterogeneity between the studies was performed using Cochran’s Q test and the I2 test. Results Two randomized controlled trials (RCTs) with a total of 117 patients and four observational cohort studies with a total of 813 patients contributed to the analysis. Pooled results indicate significant mitigation of cardiotoxicity after anthracycline and/or trastuzumab exposure among statin users in cohort studies [RR = 0.46, 95% CI (0.27–0.78), p = 0.004, $${ }I^{2}$$ I 2 = 0.0%] and a non-significant decrease in cardiotoxicity risk among statin users in RCTs [RR = 0.49, 95% CI (0.17–1.45), p = 0.20, $$I^{2}$$ I 2 = 5.6%]. Those who used statins were also significantly more likely to maintain left ventricular ejection fraction compared to baseline after anthracycline and/or trastuzumab therapy in both cohort studies [weighted mean difference (WMD) = 6.14%, 95% CI (2.75–9.52), p < 0.001, $$I^{2}$$ I 2 = 74.7%] and RCTs [WMD = 6.25%, 95% CI (0.82–11.68, p = 0.024, $$I^{2}$$ I 2 = 80.9%]. We were unable to explore publication bias due to the small number of studies. Conclusion This meta-analysis suggests that there is an association between statin use and decreased risk of cardiotoxicity after anthracycline and/or trastuzumab exposure. Larger well-conducted RCTs are needed to determine whether statins decrease risk of cardiotoxicity from anthracyclines and/or trastuzumab. Trial Registration Number and Date of Registration PROSPERO: CRD42020140352 on 7/6/2020.

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Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis

Obasi

Abovich

et al. 2021

Cancer Causes Control

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“…One study speci cally excluded patients with prior heart failure [22]. In all cohort studies, patients receiving statins had a higher prevalence of cardiovascular risk factors or established coronary artery disease [20,22,23] The primary outcome, cardiotoxicity, was examined in three cohort studies [19], [20], [22] and two RCTs [23], [24]. Two cohort studies [19], [21] and two RCTs [23], [24] also examined the secondary outcome, mean change in LV ejection fraction.…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

“…Lower quality scores arose from the omission of information in Tase and colleagues since it was a conference abstract [20].…”

Section: Quality Assessment Resultsmentioning

confidence: 99%

“…Calvillo-Arguelles et al speci cally de ned cardiotoxicity using the two-part CERC de nition as described above [19]. Tase et al and Seician et al de ned cardiotoxicity as new onset heart failure hospitalization [20], [22]. Nabati et al and Acar et al de ned cardiotoxicity as reduction in LVEF to <45% and <50%, respectively [23], [24].…”

Section: Incidence Of Cardiotoxicitymentioning

confidence: 99%

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Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: A systematic review and meta-analysis

Obasi¹,

Abovich

et al. 2021

Preprint

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Purpose: Cardiotoxicity affects 5-16% of cancer patients who receive anthracyclines and/or trastuzumab. Limited research has examined interventions to mitigate cardiotoxicity. We examined the role of statins in mitigating cardiotoxicity by performing a systematic review and meta-analysis of published studies. Methods: A literature search was conducted using PubMed, Embase, Web of Science, ClinicalTrials.gov, and Cochrane Central. A random-effect model was used to assess summary relative risks (RR), weighted mean differences (WMD), and corresponding 95% confidence intervals. Testing for heterogeneity between the studies was performed using Cochran’s Q test and the I 2 test. Results: Two randomized controlled trials (RCTs) with a total of 117 patients and four observational cohort studies with a total of 813 patients contributed to the analysis. Pooled results indicate significant mitigation of cardiotoxicity after anthracycline and/or trastuzumab exposure among statin users in cohort studies [RR=0.46, 95% CI (0.27-0.78), p=0.004, =0.0%] and a non-significant decrease in cardiotoxicity risk among statin users in RCTs [RR=0.49, 95% CI (0.17-1.45), p=0.20, =5.6%]. Those who used statins were also significantly more likely to maintain left ventricular ejection fraction compared to baseline after anthracycline and/or trastuzumab therapy in both cohort studies [weighted mean difference (WMD)=6.14%, 95% CI (2.75-9.52), p<0.001, =74.7%] and RCTs [WMD=6.25%, 95% CI (0.82-11.68, p=0.024, =80.9%]. We were unable to explore publication bias due to the small number of studies. Conclusions: This meta-analysis suggests that there is an association between statin use and decreased risk of cardiotoxicity after anthracycline and/or trastuzumab exposure. Larger well-conducted RCTs are needed to determine whether statins decrease risk of cardiotoxicity from anthracyclines and/or trastuzumab.Trial Registration Number and Date of Registration: PROSPERO: CRD42020140352 on 7/6/2020.

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Statins for the Primary Prevention of Anthracycline Cardiotoxicity: A Comprehensive Review

Bhasin,

Vakilpour,

Scherrer-Crosbie

2024

Curr Oncol Rep

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Purpose of Review The aim of this review is two-fold: (1) To examine the mechanisms by which statins may protect from anthracycline-induced cardiotoxicity and (2) To provide a comprehensive overview of the existing clinical literature investigating the role of statins for the primary prevention of anthracycline-induced cardiotoxicity. Recent Findings The underlying cardioprotective mechanisms associated with statins have not been fully elucidated. Key mechanisms related to the inhibition of Ras homologous (Rho) GTPases have been proposed. Data from observational studies has supported the beneficial role of statins for the primary prevention of anthracycline-induced cardiotoxicity. Recently, several randomized controlled trials investigating the role of statins for the primary prevention of anthracycline-induced cardiotoxicity have produced contrasting results. Summary Statins have been associated with a lower risk of cardiac dysfunction in cancer patients receiving anthracyclines. Further investigation with larger randomized control trials and longer follow-up periods are needed to better evaluate the long-term role of statin therapy and identify the subgroups who benefit most from statin therapy.

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HMG-CoA-reductase inhibitor co-therapy lowers the risk for incident heart failure in farmorubicin recipients for two cancer locations

Cited by 4 publications

References 0 publications

Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis

Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis

Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: A systematic review and meta-analysis

Statins for the Primary Prevention of Anthracycline Cardiotoxicity: A Comprehensive Review

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