Women on the cholesterol-lowering medications were significantly less likely to visit the emergency room or to be hospitalized from heart failure when on certain chemotherapy drugs than their counterparts who were not taking statins. The results were published in January 2021 in the Journal of the American Heart Association. The study looked at anthracyclines and trastuzumab, two types of cancer medications commonly used to treat breast cancer. While these medications are effective at killing cancer cells, they can also damage the cells of the heart muscle, leading to a weakening of the heart and increasing the risk of heart failure. “Anthracycline-based regimens and trastuzumab are effective treatments for many women with breast cancer,” said lead study author Husam Abdel-Qadir, MD, PhD, assistant professor of medicine at the University of Toronto’s Institute of Health Policy, Management, and Evaluation. “However, the increased risk of cardiotoxicity has limited their use.” Previous small studies have suggested women on statins may experience less damage to the heart from these chemotherapy drugs. RELATED: Cancer Risks, Signs, Symptoms, Tests, Treatments, and More
What the New Study Found
For the current study, the researchers reviewed several health databases in Ontario, Canada, to look at the occurrence of heart failure in female patients ages 66 and older who were treated with anthracyclines or trastuzumab for newly diagnosed early-stage breast cancer from 2007 to 2017. They compared equal numbers of participants taking statins and not taking statins while undergoing these cancer treatments to explore how many required an emergency room visit or hospitalization for heart failure within the first five years after receiving chemotherapy. RELATED: Diabetes Increases the Risk of Heart Failure More in Women Than in Men Of the patients treated with anthracyclines, those on statins were 55 percent less likely to need treatment at the hospital for heart failure than those who were not. The group consisted of 666 pairs of women. Just over 1 percent of the women taking statins were treated for heart failure, compared with nearly 3 percent in the non-statin group. In the 390 pairs of women treated with trastuzumab, 2.7 percent of the women on statins required treatment in the hospital for heart failure, compared to 3.7 percent of their counterparts, a difference that did not meet statistical significance, the researchers say. “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,” Dr. Abdel-Qadir said. However, he notes it’s important to understand that the study was observational and can’t conclude that there is a cause-and-effect relationship. Nor does it mean all women undergoing treatment with these chemotherapy drugs should start taking statins. “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 be.” Still, he says other factors may be at play. “For example, patients who were receiving statins could have been more health aware or had more informed doctors,” he said.
The Importance of Taking Care of Your Heart
RELATED: What Is Heart Disease? Symptoms, Cases, Diagnosis, Treatment, and Prevention Tochi M. Okwuosa, DO, chair of the American Heart Association’s cardio-oncology committee, said the results aren’t entirely surprising, given the effects of statins on heart health. “Statins lower cholesterol, which lowers the risk of heart attack, and a lower risk of heart attack leads to a lower risk of heart failure,” says Dr. Okwuosa, who is also an associate professor of medicine and cardiology and director of the cardio-oncology program at Rush University Medical Center in Chicago. “We know from past studies that people who have baseline heart disease or other comorbidities, like uncontrolled diabetes or hypertension, are at higher risk of heart failure as a result of anthracyclines. So, it’s not necessarily that surprising that people who had their hearts taken care of eventually had lower risk of having heart failure with anthracyclines exposure.” Both experts say women with breast cancer who meet established indications for a statin should make sure they continue taking it through their chemotherapy. For others, it’s important to focus on optimizing cardiovascular health before, during, and after chemotherapy. Okwuosa pointed to her own research published in 2019 in JACC: CardioOncology, a journal from the American College of Cardiology, which showed people who exercised prior to treatment with chemotherapy had a reduced risk of heart events like heart attack, stroke, and heart failure. In addition to exercise, other steps to improve heart health include eating a low-salt and low-cholesterol diet, maintaining a healthy weight, controlling blood pressure and cholesterol, not smoking, managing stress, and getting good quality sleep. “The heart is a vital organ. No one can live without a heart,” Okwuosa said. “We have to take care of our hearts before anything happens. Even if you don’t know you’re going to get cancer and be treated with anthracyclines or any other cardiotoxic chemotherapy, it’s still important to take care of our hearts. If we do that, eventually if anything happens, our heart is more resilient and more able to withstand injury that may come at it.” RELATED: Everyday health Assessment, Get Your Resilience Score
