Statins as preventive therapy for anthracycline cardiotoxicity: a meta-analysis of randomized controlled trials

• Published in: International journal of cardiology 2023-11, Vol.391, p.131219-131219, Article 131219
• Main Authors: D'Amario, Domenico, Laborante, Renzo, Bianchini, Emiliano, Galli, Mattia, Ciliberti, Giuseppe, Mennuni, Marco, Patti, Giuseppe
• Format: Article
• Language: English
• Subjects: Anthracyclines; Cardio-oncology; Cardiotoxicity; Statin
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2023.131219

Cardiotoxicity occurs in 5–20% of cancer patients who receive anthracyclines. The aim of this study was to pool all the randomized controlled trials (RCTs) investigating the cardio-protective role of statins in patients treated with anthracyclines. PubMed and Scopus electronic databases were scanned for eligible studies up to May 3rd, 2023. A total of 5 RCTs with 808 patients were included. Efficacy endpoints were the rate of anthracycline-mediated cardiotoxicity, the incidence of hospitalization for heart failure (HF), left ventricular ejection fraction (LVEF) value after anthracycline treatment, and ∆LVEF calculated as the difference in LVEF before and after anthracycline therapy. Safety endpoints [i.e., the incidence of muscle pain and serious adverse events (SAE)] were also assessed. On pooled analysis, the statin-treated group had a lower incidence of cardiotoxicity compared to the placebo group [risk ratio (RR) 0.52, 95% confidence Interval (CI) 0.33–0.83, P = 0.01; I2 = 0%], as well as higher mean LVEF [Mean difference (MD) 1.88, 95% CI 0.66–3.1, P