Patients who take statins after radiotherapy for head, neck or throat cancer have had fewer strokes and a signal for fewer cardiovascular and cerebrovascular events in general, as well as a retrospective cohort study found.
Statin administration was associated with a 32% lower risk of stroke compared to non-use (HR 0.68, P= 0.0368), reported Negareh Mousavi, MD, MHSc, Royal Victoria Hospital in Montreal, and colleagues in the Journal of the American Heart Association.
Crude myocardial infarction, stroke and transient ischemic attack rate was a similar of 9.03% among statin users and 10.31% among non-users (HR 0.92, P= 0.3451). But this association showed a "strong trend" after adjustment for prior history of these events, as well as sex, heart failure, dyslipidemia, hypertension, age, diabetes, atrial fibrillation and chronic kidney disease (HR 0.85, P= 0.0811).
"This increases the need for prospective randomized controlled trials to definitively establish the benefit of statins in this at-risk population and to set guidelines for the management of radiation-induced vascular disease," the researchers wrote.
This study is in line with previous research that supports cardiovascular prevention after cancer treatment, noted Javid Moslehi, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, who was not involved in the study. While much of the focus on cardio-oncology has been heart failure, vascular problems – particularly peripheral vascular disease – are emerging as important in this group of patients, he added.
"This means that as soon as patients complete cancer treatment or even when they are receiving cancer treatment, we should think about the survival phase," Moslehi said. MedPage Today.
The researchers evaluated 4,166 statin users and 1,552 non-state users over 75 years (mean 75) who presented in Quebec for coronary angiography, acute coronary syndrome, or coronary revascularization, as recorded in a comprehensive health insurance database the province and who received radiotherapy for head, chest or neck cancer. The cohort was 45% female.
Limitations of the study included their retrospective observational design, "making it impossible to rule out residual and non-measured confusions between non-randomized groups as an explanation for the observed outcomes," the authors write.
The researchers did not disclose relevant financial relationships with the industry.
Moslehi did not disclose any disclosures.
2019-06-19T16: 45: 00-0400