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March 03, 2021 05:00pm
By Jill Murphy, Associate Editor
Anthracyclines and trastuzumab are used in many women with breast cancer, although increased risk of toxicity has limited use of these drugs and damage can be severe enough to lead to heart failure.
New research suggests that statins, which are commonly prescribed to lower cholesterol and reduce the risk of heart disease and stroke, may also protect patients from heart damage caused by early breast cancer treatment.
The observational study found that women who were already taking statins and were treated with either anthracyclines or trastuzumab were half as likely to be hospitalized or visit an emergency department for heart failure within 5 years following chemotherapy. The researchers focused on women in Ontario, Canada, and included markers of heart failure severe enough for women to be hospitalized, rather than markers just indicating a weaker heart.
“Our job is to protect the heart and ensure it has the greatest fighting chance to get through chemotherapy,” said lead author of the paper Husam Abdel-Qadir, MD, PhD, FRCPC, DABIM, in a press release.
He added that prior observational studies have reported measures of heart strength in statin-treated women after chemotherapy, but only focused on a single center.
Anthracyclines and trastuzumab are used in many women with breast cancer, although increased risk of toxicity has limited use of these drugs and damage can be severe enough to lead to heart failure. The investigators used several health databases in Ontario to review the occurrence of heart failure in women aged 66 years and older who received trastuzumab or anthracyclines for newly diagnosed early-stage breast cancer between 2007 and 2017.
In the 666 pairs of women treated with anthracyclines, those taking statins were 55% less likely to be treated at the hospital for heart failure, according to a press release. In the 390 pairs of women treated with trastuzumab, those taking statins were 54% less likely, suggesting a protecting trend although it did not meet statistical significance.
One of the ways that the treatments are believed to damage heart muscles is through oxidative stress, defined as the imbalance of free radicals, compounds which can harm the body if levels are too high, and antioxidants, which fight free radicals. In addition to lowering cholesterol, statins may also protect the body against the effects of oxidative stress, which may decrease the likelihood of the heart sustaining damage due to cancer treatment.
“In order to know whether it’s a true cause and effect relationship, we need to do a proper randomized controlled trial,” Abdel-Qadir said. “For the time being, if a woman is supposed to be starting treatment for breast cancer and already has an established indication to be on a statin, there’s now additional motivation to start it or stay on it.”
Common drug may protect hearts from damage caused by breast cancer chemotherapy [news release]. EurekAlert; January 6, 2020. Accessed January 7, 2020. https://www.eurekalert.org/pub_releases/2021-01/uhn-cdm010521.php