Chronic statin administration may attenuate early anthracycline-associated declines in left ventricular ejection function.
Chronic statin administration may attenuate early anthracycline-associated declines in left ventricular ejection function.
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DOI：
10.1016/j.cjca.2014.11.020
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Hundley WG
中科院分区：
文献类型：
--
作者：
Chotenimitkhun R;D'Agostino R Jr;Lawrence JA;Hamilton CA;Jordan JH;Vasu S;Lash TL;Yeboah J;Herrington DM;Hundley WG
最近的研究表明，他汀类药物治疗与降低乳腺癌幸存者的心力衰竭风险之间存在关联。我们的目标是评估预防心血管疾病(CVD)的他汀类药物是否能改善在以蒽环类药物为基础的化疗(ANTH-BC)中经常观察到的左心室射血分数(LVEF)下降。在51名参与者(33名女性和18名男性；年龄48±2岁)中，我们对乳腺癌、白血病或淋巴瘤患者在ANTH-BC开始前和6个月后进行了LVEF的CV磁共振(CMR)测量。14名患者接受他汀类药物治疗，37名患者未接受他汀类药物治疗。MR图像分析师对参与者身份视而不见。服用他汀类药物的患者年龄较大，通常患有糖尿病(DM)、高血压(HTN)和高脂血症(HLD)。接受他汀类药物治疗的患者，开始服用他汀类药物后6个月的LVEF为56.6±1.4%，6个月后为54.1±1.3%(p=0.15)。对于未接受他汀类药物治疗的患者，左心室射血分数在基线时为57.5%±1.4%，在类似的6个月间隔内下降至52.4%±1.2%(p=0.0003)。在一个多变量模型中，考虑了年龄、性别、糖尿病、高脂血症、高密度脂蛋白和接受蒽环类药物的累积量，服用他汀类药物的参与者的左心室射血分数保持不变(+1.1±2.6%)，而未服用他汀类药物的参与者的−下降了6.5±1.5%(p=0.03)。总之，这些数据强调，接受他汀类药物治疗以预防心血管疾病的患者，在早期接受ANTH-BC治疗后，左心室射血分数的恶化程度可能比没有接受他汀类药物的患者要小。有必要对大量参与者进行进一步研究，以确定他汀类药物是否对接受Anth-BC治疗的患者的LVEF下降具有保护作用。
Recent studies show 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 disease (CVD) would ameliorate declines in left ventricular ejection fraction (LVEF) often observed during anthracycline-based chemotherapy (Anth-bC). In 51 participants (33 women and 18 men; aged 48±2 years), we performed CV magnetic resonance (CMR) 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 received no statin. MR image analysts were blinded to participant identifiers. Those receiving statins were older and often had diabetes (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 (p=0.15). For those not receiving a statin, 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%) versus a −6.5±1.5% decline among those not receiving a statin (p=0.03). In conclusion, these data highlight that individuals receiving statin therapy for prevention of CVD may experience less deterioration in LVEF upon early receipt of Anth-bC than individuals not receiving a statin. Further studies with large numbers of participants are warranted to determine if statins protect against LVEF decline in patients receiving Anth-bC.
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影响因子：
3.3
作者：
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