Abstract 4369513: Statin Therapy For Primary Prevention Of Anthracycline-Induced Cardiotoxicity:A Systemic Review And Meta-Analysis

Abstract

Introduction: One of the major adverse effects of cancer chemotherapeutic agents, particularly anthracyclines, is therapy-related cardiac dysfunction. This created a need to develop effective cardioprotective strategies to prevent myocardial injury post-chemotherapy. Recent studies indicate that the usage of statins provides a protective effect in chemotherapy-induced cardiotoxicity. This study aims to ascertain its efficacy by measuring outcomes such as incidence of heart failure and left ventricular ejection fraction (LVEF) change. Methodology: A systematic search was conducted using PubMed, Google Scholar, and Scopus. PRISMA guidelines were followed. A Boolean expression was constructed to retrieve and select articles from major medical databases. Articles that included observations of heart failure events in statin therapy and placebo groups for the primary prevention of anthracycline-induced cardiotoxicity were included in the meta-analysis conducted. The Odds ratio of HF events was assessed to understand the efficacy of statin therapy using the Mantel-Haenszel method(common effect model) and the Inverse variance method ( random effects model). The I^2 test was used to assess the heterogeneity. The inverse variance method was used to assess the change in mean LVEF to understand changes in systolic function. Results: The meta-analysis conducted assessed a total of 4 studies involving 620 subjects receiving statin therapy and 730 subjects in the control group. The occurrence of HF events was significantly lower in the statin therapy group, indicating its efficacy as a promising therapeutic agent in the primary prevention of anthracycline-induced cardiotoxicity.(OR = 0.48(0.33 ; 0.72) , I^2 = 0% and p = 0.90). The mean difference in change of LVEF was not significantly different between the 2 groups.(MDS = -1.76(-7.20;3.96) , I^2 = 97% , p<0.01) Conclusion: Our study suggests that statins show significantly reduced occurrence of Heart Failure events in comparison to the control group. This suggests that statins are a reliable and efficacious prophylactic agent for the prevention of cardiotoxicity induced by chemotherapeutic agents like anthracycline.