title: Chronic statin administration may attenuate early anthracycline-associated declines in left ventricular ejection function.
abstract: BACKGROUND
  Recent studies have shown an association between statin therapy and a reduced risk of heart failure among breast cancer survivors. Our goal was to evaluate whether statin therapy for prevention of cardiovascular (CV) disease would ameliorate declines in the left ventricular ejection fraction (LVEF) that is often observed during anthracycline-based chemotherapy (Anth-bC).
  
  
  METHODS
  There were 51 participants (33 women and 18 men, aged 48 ± 2 years). We obtained cardiovascular magnetic resonance imaging (CMRI) measurements of LVEF before and 6 months after initiation of Anth-bC for patients with breast cancer, leukemia, or lymphoma. Fourteen individuals received statin therapy, and 37 patients received no statins. MR image analysts were blinded to participant identifiers.
  
  
  RESULTS
  Individuals receiving statins were older and often had diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia (HLD). For those receiving statins, LVEF was 56.6% ± 1.4% at baseline and 54.1% ± 1.3% 6 months after initiating anthracycline treatment (P = 0.15). For those not receiving statins, LVEF was 57.5% ± 1.4% at baseline and decreased to 52.4% ± 1.2% over a similar 6-month interval (P = 0.0003). In a multivariable model accounting for age, sex, DM, HTN, HLD, and cumulative amount of anthracycline received, LVEF remained unchanged in participants receiving a statin (+1.1% ± 2.6%) vs a -6.5% ± 1.5% decline among those not receiving a statin (P = 0.03).
  
  
  CONCLUSIONS
  These data highlight the finding that individuals receiving statin therapy for prevention of cardiovascular disease may experience less deterioration in LVEF with early receipt of Anth-bC than individuals not receiving statins. Further studies with large numbers of participants are warranted to determine if statins protect against LVEF decline in patients receiving Anth-bC.
authors: Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Runyawan
authors: R
authors: Chotenimitkhun
authors: Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Ralph
authors: R
authors: D'Agostino
authors: Department of Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Julia A
authors: JA
authors: Lawrence
authors: Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Craig A
authors: CA
authors: Hamilton
authors: Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Jennifer H
authors: JH
authors: Jordan
authors: Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Sujethra
authors: S
authors: Vasu
authors: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors: Timothy L
authors: TL
authors: Lash
authors: Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Joseph
authors: J
authors: Yeboah
authors: Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: David M
authors: DM
authors: Herrington
authors: Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. Electronic address: ghundley@wfubmc.edu.
authors: W Gregory
authors: WG
authors: Hundley
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000069059:Atorvastatin; D005260:Female; D006333:Heart Failure / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D011758:Pyrroles / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D019821:Simvastatin / Q000627:therapeutic use*; D013318:Stroke Volume / Q000187:drug effects*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin