Abstract
Background: According to the current guideline, statins should be provided to prevent anthracycline cardiotoxicity in high-risk cancer patients. This study aims to investigate the role of atorvastatin in preventing anthracycline-induced cardiac dysfunction among low-risk breast cancer patients. Methods: In this randomized, double-blinded, placebo-controlled trial, newly diagnosed breast cancer patients with low risk of cancer therapy-related cardiac dysfunction (CTRCD) were assigned to receive atorvastatin 40 mg or placebo. Echocardiography was performed before, at 3 and 6 months after the anthracycline treatment to determine changes in LVEF as a primary outcome. The secondary outcome included changes in global longitudinal strain (GLS), LV volume, high-sensitivity troponin T levels, the incidence of CTRCD and side effects from atorvastatin. Results:
A total of 40 patients were enrolled. The post-anthracycline LVEF was significantly reduced compared with the baseline in both groups. The post-anthracycline LVEF reduction was lower in the atorvastatin group, however, not statistically significant (4% in the placebo group vs 2% in the atorvastatin group; p = 0.32). LV Volume, GLS, and troponin T levels did not change after anthracycline in both groups. The incidence of CTRCD was similar in both groups (3 (14%) in placebo, 3 (15%) in atorvastatin; p value 0.89) Conclusions: In low-risk breast cancer patients, atorvastatin does not show significant benefit in lessening the reduction of LVEF at 6 months post-anthracycline treatment. There were no differences observed in GLS changes, troponin levels, or the incidence of CTRCD between the atorvastatin and placebo groups.
Recommended Citation
Chonthicha Tanking, Chanwit Wuttichaipradit, Chayanee Samdaengpan, Jomtana Siripaibun, Siriwan Manahwan,R.N, Bundhitwong Trikesornnopamas, Phakawan Budchala, Viroj Muangsillapasart, Atorvastatin in Preventing Anthracycline-Induced Cardiotoxicity in Low-Risk Breast Cancer Patients: A Randomized Controlled Trial (ATOPACT-low) Journal of the Hong Kong College of Cardiology 2024;31(6) https://doi.org/10.55503/2790-6744.1545
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