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Are Statins Preventive Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracyclines? A Single Center Retrospective Analysis
Session:
Sessão de Posters 12 - Cardio-oncologia e Medicina na Gravidez
Speaker:
Cátia Oliveira
Congress:
CPC 2024
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Cartazes
FP Number:
---
Authors:
Cátia Oliveira; Luís Santos; Ana Pinho; Pedro Palma; Helena Moreira; Miguel Rocha; André Cabrita; Catarina Marques; Mariana Paiva; Carla Sousa; Filipe Macedo
Abstract
<p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12px"><strong>Introduction/Purpose: </strong>Anthracyclines (AC) have long been proved to be associated with a significant risk of cardiotoxicity (CT). We aimed to evaluate the impact of statins in preventing CT in patients with breast cancer (BC). </span></span></p> <p style="text-align:justify"><br /> <span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12px"><strong>Methods: </strong>We retrospectively analyzed a population of BC female patients (pts) treated with AC referred to Cardio-Oncology outpatient clinic from January 2017 to November 2021. All pts had a clinical and echocardiographic evaluation before treatment, at 3, 6 months and 12-months after finishing oncologic treatment. Baseline CT risk was defined according to the HFA-ICOS risk assessment tool. CT was defined as LVEF<50% and/or GLS variation>15% during follow-up. As cardioprotective drugs (CPD), we considered beta-blockers and renin-angiotensin-aldosterone system inhibitors. </span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12px"><strong>Results: </strong>A total of 271 pts were included with a mean age of 49.9±5.6 years-old. During a median follow-up time of 14.8±5.5 months, 30.9% patients developed CT. The overall prevalence was similar in pts on AC and on AC plus anti-HER2 therapy (AHT) (27.2% vs 35.9%, p=0.131), but it was more severe in the latter group (moderate/severe 1.8% vs 7.8%, p=0.038). Overall, 20.4% of the pts were medicated with statins before oncologic treatment. Comparing those medicated with statins with those who weren’t, the former group had tendentially less CT (20.4% vs 33.8%, p=0.057). Regarding severity of dysfunction, there were no differences between the groups.<br /> Pts on statins had a significantly higher cardiovascular (CV) risk (≥2 CV risk factors: 64.8% vs 18.35%, p<0,001) and CT risk (moderate to very high risk: 57,4% vs 31,8%, p<0,001 ). Regarding CPD, 57,4% of the statins group were also medicated with CPD, compared to 30,8% of the remaining pts (p<0.001).<br /> Overall, 48% pts recovered, 63.6% in the statins group compared to 46.5% in the group not medicated (p = 0.103). Regarding echocardiographic outcomes, LVEF at 12 months was similar between groups, but the statins group seemed to recover faster (figure 1). GLS was similar at 12 months between groups.</span></span></p> <p style="text-align:justify"><br /> <span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12px"><strong>Conclusion: </strong>Patients exposed to AC had a significant risk of developing CT, which was more severe when concurrently on AHT. Pts medicated with statins had a tendentially less CT, which indicates that statins might prevent cardiac dysfunction. These results highlight the importance of cardiac monitoring and give some strength to the value of statins as primary prevention, especially considering the results of recent trials.</span></span></p>
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