Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University, PO Box 980335, Richmond, VA, 23298, USA.
Curr Oncol Rep. 2022 May;24(5):555-561. doi: 10.1007/s11912-022-01212-4. Epub 2022 Feb 24.
Although cancer treatments have increased overall survival rates, the cardiovascular consequences of cancer therapy place patients at an increased risk of adverse outcomes. This manuscript presents data accumulated to date regarding cardiovascular outcomes relating to the administration of 3-hydroxy-3-methylglutarylcoenzyme-A reductase inhibitor (or statin) therapy in individuals receiving potentially cardiotoxic cancer treatments.
Retrospective observational studies in humans and randomized controlled trials in animals suggest that statins may reduce cancer-specific and all-cause mortality. Further, statins may attenuate cancer therapy-induced declines in left ventricular ejection fraction (LVEF) and increases in blood pressure. Observational studies suggest a potential attenuation in LVEF decline in patients with cancer and primary or secondary indications to receive a statin for prevention of cardiovascular events. Large randomized clinical trials are warranted to understand the efficacy and potential impacts of statin class, dosage, and duration on cardiovascular outcomes in patients treated for cancer.
尽管癌症治疗提高了总生存率,但癌症治疗的心血管后果使患者发生不良结局的风险增加。本文介绍了迄今为止关于接受潜在心脏毒性癌症治疗的个体中,3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂(他汀类药物)治疗与心血管结局相关的数据。
在人类中的回顾性观察性研究和动物中的随机对照试验表明,他汀类药物可能降低癌症特异性和全因死亡率。此外,他汀类药物可能减轻癌症治疗引起的左心室射血分数(LVEF)下降和血压升高。观察性研究表明,对于有癌症和原发性或继发性适应证接受他汀类药物预防心血管事件的患者,他汀类药物可能会减轻 LVEF 下降。需要进行大型随机临床试验,以了解他汀类药物类别、剂量和持续时间对癌症治疗患者心血管结局的疗效和潜在影响。