Atorvastatin Pretreatment Protects Vascular Function in Lymphoma Patients receiving anthracycline-based chemotherapy: JAMA
A recent study published in the Journal of the American Medical Association revealed that pretreatment with atorvastatin helped preserve vascular function in lymphoma patients receiving anthracycline-based chemotherapy.
Anthracyclines, powerful chemotherapy drugs central to many cancer protocols, are known for their effectiveness against malignancies like lymphoma, but they also carry a well-documented risk of cardiovascular toxicity. One of the earliest and most concerning effects is increased vascular stiffness, a predictor of later heart failure, stroke, and other cardiovascular diseases.
This research from 9 academic centers across the U.S. and Canada examined whether pretreatment with atorvastatin could reduce this risk. Between 2017 and 2021, 300 patients newly diagnosed with lymphoma and scheduled to receive anthracycline-based chemotherapy were enrolled in this clinical trial. None of the participants had prior indications for statin use. They were randomly assigned to receive either atorvastatin (40 mg daily) or a placebo for 12 months.
In this subanalysis, the team focused on the aortic arch pulse wave velocity (PWV) and aortic distensibility (AD), which reflects the ability of aorta to expand and contract with blood flow. Measurements were taken using cardiac magnetic resonance imaging (MRI) at baseline and after one year.
The results found average PWV values remained stable over 12 months (6.5 m/s at baseline vs. 6.5 m/s after treatment), among patients who received atorvastatin. In contrast, those on placebo saw a significant increase which indicated stiffer arteries. When comparing the proportions, only 5% of atorvastatin-treated patients experienced a significant (≥1 standard deviation) increase in arterial stiffness, versus 50% in the placebo group. Statin users were, therefore, 95% less likely to develop increased aortic stiffness (odds ratio 0.05; 95% CI, 0.02–0.16; P < .001).
Similarly, deterioration in aortic distensibility occurred in 7% of atorvastatin users when compared with 18% of those on placebo, which suggested the drug to preserve vascular elasticity. Also, increases in PWV correlated with declines in left ventricular ejection fraction by an average of 2.7%. Overall, these findings highlight the potential of atorvastatin to preserve vascular function in patients undergoing anthracycline therapy.
Reference:
Juhasz, V., Drobni, Z. D., Quinaglia, T., Gilman, H. K., Brendel, J. M., Suero-Abreu, G. A., Ghamari, A., Heemelaar, J. C., Neuberg, D. S., Han, Y., Ky, B., Kwong, R. Y., Januzzi, J. L., Asnani, A., Mousavi, N., Redd, R. A., Jerosch-Herold, M., Scherrer-Crosbie, M., & Neilan, T. G. (2025). Atorvastatin and aortic stiffness during anthracycline-based chemotherapy: A secondary analysis of a randomized clinical trial: A secondary analysis of a randomized clinical trial. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2025.4548
