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Effect of statin therapy on the risk for incident heart failure in patients with breast cancer receiving anthracycline chemotherapy: An observational clinical cohort study

Citation

Seicean, S and Seicean, A and Plana, JC and Budd, GT and Marwick, TH, Effect of statin therapy on the risk for incident heart failure in patients with breast cancer receiving anthracycline chemotherapy: An observational clinical cohort study, Journal of the American College of Cardiology, 60, (23) pp. 2384-2390. ISSN 0735-1097 (2012) [Refereed Article]

Copyright Statement

Copyright 2012 by the American College of Cardiology Foundation

DOI: doi:10.1016/j.jacc.2012.07.067

Abstract

Objectives: The aim of this study was to evaluate the effect of continuous statin treatment on new-onset heart failure (HF) in patients with breast cancer receiving anthracycline-based chemotherapy.

Background: In vitro and animal model experimental studies have reported that statins prevent doxorubicin-induced cardiotoxicity.

Methods: A total of 628 women with newly diagnosed breast cancer (mean age 51.510.8 years) treated with anthracycline were retrospectively identified and studied. The primary outcome (incident HF hospitalization) was compared in propensity-matched patients receiving uninterrupted statin therapy through the follow-up period of 2.55 1.68 years and their counterparts not receiving continuous statin therapy.

Results: After propensity matching (2:1), the 67 patients (10.7%) receiving uninterrupted statin therapy were combined with 134 controls. New-onset HF was observed in 67 of the 201 matched patients. Multivariate-matched Cox regression analysis showed a significantly lower hazard ratio [HR] of 0.3 (95% confidence interval [CI]: 0.1 to 0.9; p=0.03) for patients taking uninterrupted statin therapy. Cardiotoxicity risk factors at the time of cancer diagnosis (HR: 5.0; 95% CI: 2.2 to 11.1; p<0.001), baseline ejection fraction <55% (HR: 2.7; 95% CI: 1.2 to 6.3; p=0.02), and trastuzumab use (HR: 3.0; 95% CI: 1.3 to 7.2; p=0.01) were predictors of incident HF.

Conclusions: In this analysis of female patients with breast cancer treated with anthracycline chemotherapy, statin use was associated with a lower risk for incident HF. This finding is consistent with prior animal studies and warrants further investigation through prospective randomized clinical trials.

Item Details

Item Type:Refereed Article
Keywords:anthracyclines, breast cancer, heart failure, statins
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
ID Code:82259
Year Published:2012
Web of Science® Times Cited:86
Deposited By:Menzies Institute for Medical Research
Deposited On:2013-01-23
Last Modified:2015-07-10
Downloads:0

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