Statin use may improve cancer-related survival in breast cancer patients: JAMA

The researchers found that other cardiovascular outcomes, including arterial and venous events and heart failure, were similar between statin users and nonusers. They say more investigations, specifically randomized clinical trials, are needed to support the findings.

Previous studies have shown in addition to protective effects on the cardiovascular system; statins may lower the risk of breast cancer recurrence owing to potential anti-inflammatory benefits. Whether statins use in patients with breast cancer in Asia can improve survival is uncertain given that these patients are relatively younger at diagnosis, and most are free from traditional cardiovascular (CV) risk factors.

Against the above background, Wei-Ting Chang, National Cheng Kung University, Tainan, Taiwan, and colleagues investigated the association of statin use with cancer- and noncancer-associated survival in breast cancer patients in a cohort study.

They used the National Cancer Registry and Taiwanese National Health Insurance Research Database to identify patients with breast cancer diagnoses from 2012 to 2017. Using the propensity score method, they matched cancer stage, age, cardiovascular drugs, socioeconomic status, comorbidities, and anticancer therapies. The mean follow-up duration was 4.10 years.

The study compared patients receiving stations within six months before breast cancer diagnosis with those not receiving statins. The study's outcomes were death, arterial and venous events, and heart failure.

The authors reported the following findings:

• Seven thousand four hundred fifty-one patients (mean age, 64.3 years) treated with statins were matched with 7451 nonusers (mean age, 65.8 years).
• Compared with nonusers, statin users had a significantly lower risk of all-cause death (adjusted hazard ratio [HR], 0.83).
• The risk reduction was mainly attributed to cancer-related death (adjusted HR, 0.83).
• Only a few patients died of cardiovascular causes; the ratios were similar between statin users and nonusers.
• The researchers did not observe significant differences between statin users and nonusers in cardiovascular outcomes, including heart failure and arterial and venous events.
• Using a time-dependent analysis, statin users also presented a significantly lower risk of cancer-related death (adjusted HR, 0.28) than nonusers, and the risk notably was even lower in high-dose statin (HDS) users compared with non-HDS users (HDS users: adjusted HR, 0.84; non-HDS users: adjusted HR, 0.79).

"Findings from a cohort study of Asian patients with breast cancer showed that statin use was linked with a lower risk of cancer-associated death rather than cardiovascular death," the researchers wrote. "Our findings provide evidence to support statin use in breast cancer patients; however, randomized studies are necessary."

Reference:

Chang W, Lin H, Lin S, Li Y. Association of Statin Use With Cancer- and Noncancer-Associated Survival Among Patients With Breast Cancer in Asia. JAMA Netw Open. 2023;6(4):e239515. doi:10.1001/jamanetworkopen.2023.9515