Statin Use Can Attenuate the Decline in Left Ventricular Ejection Fraction and the Incidence of Cardiomyopathy in Cardiotoxic Chemotherapy Recipients: A Systematic Review and Meta-Analysis

Abstract

There is insufficient evidence about the cardioprotective effects of statins against chemotherapy-induced cardiomyopathy. The MEDLINE and EMBASE databases were searched from inception to March 2021 for studies that reported the mean left ventricular ejection fraction (LVEF) before and after chemotherapy and the incidence of chemotherapy-induced cardiotoxicity in patients who received concurrent statin therapy and those who received chemotherapy alone. A random effects meta-analysis was performed to obtain the pooled weighted mean difference (WMD) and the 95% confidence interval (CI) for the mean final LVEF and the mean LVEF change, and the pooled odds ratio (OR) and the 95% CI of the incidence of chemotherapy-induced cardiomyopathy. Seven studies with 3042 patients were included in this meta-analysis (statin group: 1382 patients received concurrent statin with chemotherapy; control group: 1660 patients received chemotherapy alone). Patients in the control group had a more significant decline in LVEF (WMD = −6.08%, 95% CI: −8.55 to −3.61, p < 0.001) compared to those in the statin group. Additionally, the statin group had a significantly lower incidence of chemotherapy-induced cardiomyopathy compared to the control group (OR = 0.41, 95% CI = 0.28–0.60, p < 0.001). Consequently, our study showed a significant reduction in the incidence of chemotherapy-induced cardiomyopathy and the degree of LVEF decline in patients in the statin group compared to those in the control group.

Multiscale mapping of transcriptomic signatures for cardiotoxic drugs

“…Figure 18). This is supported by recommended treatment of cardiomyopathy and drug-induced cardiomyopathy with statins 41 and neprilysin 42,43 , respectively. Prediction of extracellular collagen-crosslinking (Suppl.…”

Guideline-directed medical therapy in chemotherapy-induced cardiotoxicity and heart failure: current perspectives and practices

“…Statins are widely prescribed medications for lowering cholesterol levels and reducing the risk for cardiovascular diseases. Although the cardioprotective effects of statins against CIC have not been sufficiently investigated [59] , current evidence suggests that the incidence of CIC may be significantly lower in patients receiving concurrent statin therapy than in those receiving chemotherapy alone. Digoxin is an effective treatment for CIC, including anthracycline-induced cardiotoxicity, and may have an anti-cancer effect.…”

Cardiovascular toxicity from therapies for light chain amyloidosis

“…Evidence from several studies suggests that a healthy lifestyle, such as not smoking, maintaining physical activity, a healthy diet (high intake of vegetables, fruits and whole grains), moderate consumption of alcohol, and modest sleep duration, results in a decreased risk of transition from cancer to subsequent CV disease ( 33 ). Moreover, adult patients at high and very high risk selected for cancer therapy, such as those with AL amyloidosis, may be treated with cardioprotective drugs including statins (Class IIa, Level B) and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers plus beta-blockers (Class IIa, Level C) for primary CV prevention ( 6 , 34 ). Finally, among patients with AL amyloidosis, an echocardiogram is recommended before starting cancer therapy (Class I, Level C) to assess left and right ventricular function, dilation, hypertrophy, wall motion abnormalities and other parameters which may influence the therapeutic strategy ( 6 , 35 ).…”