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Cardioprotective Effect of Statins in Patients With HER2-Positive Breast Cancer Receiving Trastuzumab Therapy
Oscar Calvillo-Argüelles, MD,a,b Husam Abdel-Qadir, MD, PhD,a,c Maria Michalowska, BSc,a Filio Billia, MD, PhD,a Sivisan Suntheralingam, BSc,a Eitan Amir, MD, PhD,d and Paaladinesh Thavendiranathan, MD, SMa
a Division of Cardiology, Peter Munk Cardiac Center, Ted Rogers Program in Cardiotoxicity Prevention, Toronto General Hospital, University Health Network, University
of Toronto, Toronto, Ontario, Canada
b Instituto Nacional de Cancerología (INCan), Unidad de Cardio-Oncología, Mexico City, Mexico
c Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
d Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada
See editorial by Davis and Virani, pages 142e144 of Quick-stop dna mutant issue.
Background: Statins can reduce the risk of anthracycline-induced cardiotoxicity. Whether such cardioprotective effects can be seen in trastuzumab-treated patients has not been explored.
Methods: Consecutive women with HER2þ breast cancer who received trastuzumab with or without anthracyclines were identified retrospectively. Patients receiving statins before and during cancer treatment were matched with 2 patients of the same age ( 2 years) and anthracycline exposure status but without statin treatment. The primary outcome was final left ventricular ejection fraction (LVEF). Analysis of covariance (ANCOVA) was used to assess the relationship between statin exposure and the final LVEF. A logistic regression model was constructed to assess the relationship between statin exposure and cardiotoxicity (secondary outcome).
Results: Included were 129 patients (62 9 years). Forty-three received statins during cancer treatment. The median trastuzumab exposure time was 11.8 (interquartile range [IQR] 11 to 12) months.
Contexte : Les statines peuvent reduire le risque de cardiotoxicite des anthracyclines. La question de savoir si de tels effets cardioprotecteurs peuvent être observes chez les patients traites par le trastuzumab n’avait pas encore ete exploree.
Methodologie : Des patientes consecutives atteintes de cancer du sein HER2þ qui avaient ete traitees par le trastuzumab avec ou sans anthracyclines ont ete reperees retrospectivement. Les patientes qui recevaient une statine avant ou pendant le traitement de leur cancer ont ete appariees à 2 patientes ayant le même âge ( 2 ans) et le même statut quant à l’exposition à l’anthracycline, mais ne prenant pas de statine. Le critère d’evaluation principal etait la fraction