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Correspondence to Author: Ridda Khattak¹ , DO, Rohab Sohail¹ , MD, Zaraq Khan² , MBChB BMedSci, Prakhar Anand² , MB BCh BAO, Andrei Feldiorean² MB Bch BAO, Marcos Alberto Jr.² , MD, Vyom Patel² , DO, Mark Georgy² , MB BCh BAO, Iftikhar Khan³ , MD. 

1. Department of Internal Medicine, Bayhealth Medical Center, Dover, Delaware, USA.
2. Department of Internal Medicine, Indiana University School of Medicine Southwest, Evansville, Indiana, USA.
3. Department of Hematology and Oncology, Bayhealth Medical Center, Dover, Delaware, USA.

DOI: 10.52338/tjoco.2025.4970

Abstract:

Introduction: Anthracyclines are standard chemotherapeutic agents for breast cancer but may cause dose-dependent, irreversible myocardial damage (class I cardiotoxicity) via reactive oxygen species (ROS), potentially leading to dilated cardiomyopathy and heart failure. Statins, through their pleiotropic effects, reduce oxidative stress and inflammation, offering cardioprotection. This meta-analysis evaluates the impact of statins on cardiac dysfunction, LVEF, LVESV, LVEDV, and LA diameter in women with breast cancer receiving anthracycline-based chemotherapy.
Methods: PubMed, Google Scholar, and Cochrane Library were searched through February 11, 2025, for randomized controlled trials and propensity-matched observational studies comparing statins with placebo in breast cancer patients on anthracyclines. Outcomes included changes in cardiac dysfunction, LVEF, LVESV, LVEDV, and LA diameter. A review manager was used to analyze data as mean differences with 95% confidence intervals (CI).
Results:A total of 428 patients were included; 180 (42%) in the statin group and 248 (58%) in the placebo group. Statin users had a significantly lower risk of cardiac dysfunction (RR=0.41 [95% CI: 0.23–0.72], P=0.02, I²=0%). They also had reduced LVEF decline (MD= -3.42 [CI: -5.10 to -1.73], P<0.0001, I²=20%) and two-chamber LVESV (MD= -4.87 [CI: -7.64 to -2.10], P=0.0006, I²=0%). No significant changes were seen in LA diameter or LVEDV/ LVESV across other views
Conclusion: Statins significantly reduce early cardiac dysfunction risk by 59% in breast cancer patients receiving anthracyclines. Benefits were observed in LVEF and LVESV, though limited by small sample size and data variability.

Keywords: Anthracyclines, Cardiotoxicity, Statins, Cardio-Protective Effect, Left Ventricular Ejection Fraction

Citation:

Dr. Ridda Khattak, Efficacy Of Statins In Preventing AnthracyclineInduced Cardiotoxicity In Individuals With Breast Cancer: A Systematic Review And Meta-Analysis. The Journal of Clinical Oncology 2025.