Division of Cardiovascular Medicine and Thalheimer Center for Cardio-Oncology, Perelman Center for Advanced Medicine and Hospital of the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, USA.
Curr Oncol Rep. 2024 Oct;26(10):1197-1204. doi: 10.1007/s11912-024-01579-6. Epub 2024 Jul 13.
The aim of this review is two-fold: (1) To examine the mechanisms by which statins may protect from anthracycline-induced cardiotoxicity and (2) To provide a comprehensive overview of the existing clinical literature investigating the role of statins for the primary prevention of anthracycline-induced cardiotoxicity.
The underlying cardioprotective mechanisms associated with statins have not been fully elucidated. Key mechanisms related to the inhibition of Ras homologous (Rho) GTPases have been proposed. Data from observational studies has supported the beneficial role of statins for the primary prevention of anthracycline-induced cardiotoxicity. Recently, several randomized controlled trials investigating the role of statins for the primary prevention of anthracycline-induced cardiotoxicity have produced contrasting results. Statins have been associated with a lower risk of cardiac dysfunction in cancer patients receiving anthracyclines. Further investigation with larger randomized control trials and longer follow-up periods are needed to better evaluate the long-term role of statin therapy and identify the subgroups who benefit most from statin therapy.
本篇综述的目的有二:(1)研究他汀类药物预防蒽环类药物诱导性心脏毒性的作用机制;(2)全面概述现有的他汀类药物预防蒽环类药物诱导性心脏毒性的临床研究。
他汀类药物的潜在心脏保护机制尚未完全阐明。与抑制 Ras 同源(Rho)GTP 酶有关的关键机制已被提出。观察性研究的数据支持他汀类药物在预防蒽环类药物诱导性心脏毒性中的有益作用。最近,几项关于他汀类药物预防蒽环类药物诱导性心脏毒性的随机对照试验得出了相互矛盾的结果。他汀类药物与接受蒽环类药物治疗的癌症患者的心脏功能障碍风险降低相关。需要进行更大规模的随机对照试验和更长的随访期,以更好地评估他汀类药物治疗的长期作用,并确定最受益于他汀类药物治疗的亚组。