Statins may protect women's hearts from damage caused by chemotherapy taken for early-stage breast cancer, according to new research published in the Journal of the American Heart Association.
"Two types of cancer medications, anthracyclines and trastuzumab, are effective treatments for many women with breast cancer, however, the risk of heart muscle damage has limited their use, particularly in women who are at higher risk for heart problems because of their age or other medical issues," said Husam Abdel-Qadir, M.D., Ph.D., lead author of the study, assistant professor of medicine at the University of Toronto's Institute of Health Policy, Management and Evaluation, and a cardiologist at Women's College Hospital and the Peter Munk Cardiac Centre, part of the University Health Network in Toronto.
"The mechanisms for these medications are essential to kill breast cancer cells, however, these processes can also damage the cells of the heart muscle, leading to weakening of the heart," he said.
Researchers used various administrative health databases in Ontario, Canada, to review the occurrence of heart failure in women aged above 66 who received anthracyclines or trastuzumab for new women diagnosed with early-stage breast cancer between 2007 and 2017.
Every woman taking statins was matched with a peer who was not taking statins as well as a variety of medical and social background factors.
The two groups were compared to understand how many required hospitalizations or an emergency room visit for heart failure within the five years after chemotherapy. None had previously been diagnosed with heart failure.
Among 666 pairs of women with a median age 69 years treated with anthracyclines, those taking statins were 55% less likely to be treated at the hospital for heart failure. In the 390 pairs of women treated with trastuzumab, those taking statins were 54% less likely to be treated at the hospital for heart failure..
"Our findings support the idea that statins may be a potential intervention for preventing heart failure in patients receiving chemotherapy with anthracyclines and potentially trastuzumab," Abdel-Qadir said.
This study found a link but cannot conclude that there is a cause-and-effect relationship between taking statins and a lower risk of heart failure.
"This study does not conclusively prove statins are protective," Abdel-Qadir said. "However, this study builds on the body of evidence suggesting that they may have benefits. For women with breast cancer who meet established indications for taking a statin, they should ideally continue taking it throughout their chemotherapy treatment.
Women who do not have an indication for a statin should ask their health care team if they can join a clinical trial after knowing the benefits of statins in protecting heart muscle damage caused by chemotherapy. Otherwise, they should focus on measures to optimize their cardiovascular health before, during and after chemotherapy."
Limitations are that the findings from this study may not be generalizable and it is a retrospective analysis that relied on administrative data, and the researchers could not account for potentially important factors that were not available, including the heart's pumping ability and heart biomarkers.