Statins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines
Authors' conclusion
In patients at increased risk of CTRCD, primary prevention with atorvastatin during anthracycline therapy did not ameliorate early LVEF decline, LV remodeling, CTRCD, change in serum cardiac biomarkers, or CMR myocardial tissue changes.
Study context
- Population
- Patients with cancer at increased risk of anthracycline-related cancer therapy-related cardiac dysfunction (CTRCD) (per ASCO guidelines) receiving anthracyclines
- Participants
- 112 patients
- Comparison
- Atorvastatin 40 mg vs placebo once daily
- Atorvastatinn = 54
- Placebon = 58reference
- Primary endpoint
- Post-anthracycline LVEF on CMR, adjusted for baseline
- Follow-up
- Within 4 weeks after anthracyclines
Methodological detailsmulticentre, double-blind, placebo-controlled, Post-anthracycline cardiovascular magnetic resonance (CMR) performed 22 (13-27) days from last anthracycline dose
- Multicentre
- Double-blind
- Placebo-controlled
- Post-anthracycline CMR performed 22 (13-27) days from last anthracycline dose
Primary result
As reported in the abstract
Post-anthracycline LVEF
P = 0.34
Secondary outcomes
Left ventricular (LV) end-diastolic and end-systolic volume, CMR myocardial edema and/or fibrosis, peak high sensitivity troponin I (hsTnI), BNP · post-anthracycline
- No significant between-group difference in LV end-diastolic volume
- P = 0.20
- No significant between-group difference in LV end-systolic volume
- P = 0.12
- No significant between-group difference in CMR myocardial edema and/or fibrosis
- P = 0.06-0.47
- No significant between-group difference in peak hsTnI
- P ≥ 0.99
- No significant between-group difference in BNP
- P = 0.23
CTRCD incidence (fall in left ventricular ejection fraction (LVEF) by >10% to <53%)
- CTRCD incidence similar (4% vs 4%)
- P ≥ 0.99
Safety
- No difference in adverse events
Original publication
Statins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines. Eur Heart J Cardiovasc Pharmacother. Published 29 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it