Statins Linked to Fewer Strokes After Cancer Radiation

Patients taking statins after radiation therapy for head, neck, or throat cancer, had fewer strokes and a signal for fewer cardiovascular and cerebrovascular events overall as well, a retrospective cohort study found.

Taking statins was linked to a 32% lower risk of stroke compared with non-use (HR 0.68, P=0.0368), reported Negareh Mousavi, MD, MHSc, of the Royal Victoria Hospital in Montreal, and colleagues in the Journal of the American Heart Association.

The crude myocardial infarction, stroke, and transient ischemic attack rate was a similar 9.03% among statin users and 10.31% among nonusers (HR 0.92, P=0.3451). But this association showed a “strong trend” after adjusting 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 raises the need for prospective randomized controlled trials to definitively establish the benefit of statins in this at-risk population and to define guidelines on the management of radiation-induced vascular disease,” the investigators wrote.

This study is in line with prior research supporting cardiovascular prevention after cancer treatment, noted Javid Moslehi, MD, of the Vanderbilt University Medical Center in Nashville, Tennessee, who was not involved in the study. Although much of the focus in cardio-oncology has been on heart failure, vascular issues — particularly peripheral vascular disease — are emerging as important in this patient group, he added.

“It means that as soon as patients are done with treatment for cancer or even as they are getting treatment for cancer, we should think about the survivorship phase,” Moslehi told MedPage Today.

The researchers evaluated 4,166 statin users and 1,552 nonstatin users over age 65 (mean 75) who presented in Quebec for coronary angiography, acute coronary syndrome, or coronary revascularization as recorded in a province-wide administrative health insurance database and who had received radiotherapy for head, thorax, or neck cancer. The cohort was 45% female.

Limitations of the study included its observational, retrospective design, “making it impossible to rule out residual and unmeasured confounding between nonrandomized groups as an explanation for observed results,” the authors wrote.