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Statin Exposure and Risk of Heart Failure After Anthracycline- or Trastuzumab-Based Chemotherapy for Early Breast Cancer: A Propensity Score‒Matched Cohort Study.
Abdel-Qadir, Husam; Bobrowski, David; Zhou, Limei; Austin, Peter C; Calvillo-Argüelles, Oscar; Amir, Eitan; Lee, Douglas S; Thavendiranathan, Paaladinesh.
Afiliação
  • Abdel-Qadir H; Division of Cardiology and Department of Medicine Women's College Hospital Toronto Ontario Canada.
  • Bobrowski D; Ted Rogers Centre for Heart Research and the Division of Cardiology Peter Munk Cardiac CenterUniversity Health Network Toronto Ontario Canada.
  • Zhou L; ICES (formerly the Institute for Clinical Evaluative Sciences) Toronto Ontario Canada.
  • Austin PC; Institute of Health Policy Management and EvaluationUniversity of Toronto Ontario Canada.
  • Calvillo-Argüelles O; Division of Cardiology and Department of Medicine Women's College Hospital Toronto Ontario Canada.
  • Amir E; Ted Rogers Centre for Heart Research and the Division of Cardiology Peter Munk Cardiac CenterUniversity Health Network Toronto Ontario Canada.
  • Lee DS; ICES (formerly the Institute for Clinical Evaluative Sciences) Toronto Ontario Canada.
  • Thavendiranathan P; ICES (formerly the Institute for Clinical Evaluative Sciences) Toronto Ontario Canada.
J Am Heart Assoc ; 10(2): e018393, 2021 01 19.
Article em En | MEDLINE | ID: mdl-33401953
ABSTRACT
Background Statins are hypothesized to reduce the risk of cardiotoxicity associated with anthracyclines and trastuzumab. Our aim was to study the association of statin exposure with hospitalization or emergency department visits (hospital presentations) for heart failure (HF) after anthracycline- and/or trastuzumab-containing chemotherapy for early breast cancer. Methods and Results Using linked administrative databases, we conducted a retrospective cohort study of women aged ≥66 years without prior HF who received anthracyclines or trastuzumab for newly diagnosed early breast cancer in Ontario between 2007 to 2017. Statin-exposed and unexposed women were matched 11 using propensity scores. Trastuzumab-treated women were also matched on anthracycline exposure. We matched 666 statin-discordant pairs of anthracycline-treated women and 390 pairs of trastuzumab-treated women (median age, 69 and 71 years, respectively). The 5-year cumulative incidence of HF hospital presentations after anthracyclines was 1.2% (95% CI, 0.5%-2.6%) in statin-exposed women and 2.9% (95% CI, 1.7%-4.6%) in unexposed women (P value, 0.01). The cause-specific hazard ratio associated with statins in the anthracycline cohort was 0.45 (95% CI, 0.24-0.85; P value, 0.01). After trastuzumab, the 5-year cumulative incidence of HF hospital presentations was 2.7% (95% CI, 1.2%-5.2%) in statin-exposed women and 3.7% (95% CI, 2.0%-6.2%) in unexposed women (P value 0.09). The cause-specific hazard ratio associated with statins in the trastuzumab cohort was 0.46 (95% CI, 0.20-1.07; P value, 0.07). Conclusions Statin-exposed women had a lower risk of HF hospital presentations after early breast cancer chemotherapy involving anthracyclines, with non-significant trends towards lower risk following trastuzumab. These findings support the development of randomized controlled trials of statins for prevention of cardiotoxicity.
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Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Antraciclinas / Inibidores de Hidroximetilglutaril-CoA Redutases / Cardiotoxicidade / Trastuzumab / Insuficiência Cardíaca Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans País/Região como assunto: America do norte Idioma: En Revista: J Am Heart Assoc Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Temas: Geral / Tipos_de_cancer / Outros_tipos Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Antraciclinas / Inibidores de Hidroximetilglutaril-CoA Redutases / Cardiotoxicidade / Trastuzumab / Insuficiência Cardíaca Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans País/Região como assunto: America do norte Idioma: En Revista: J Am Heart Assoc Ano de publicação: 2021 Tipo de documento: Article