Statins tied to lower risk for stroke after cancer radiotherapy

  • Boulet J & al.
  • J Am Heart Assoc
  • 2 Jul 2019

  • International Clinical Digest
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Takeaway

  • Cancer survivors who had received radiation therapy to the thorax, head, or neck had a nearly one-third lower risk for stroke if they used statins.

Why this matters

  • Radiation therapy can induce atherosclerosis, increasing risk for cardiovascular, cerebrovascular events.

Key results

  • Primary composite vascular outcome: 10.3% for statin nonusers (mean follow-up, 534 days) vs 9.0% for statin users (mean follow-up, 594 days; HR, 0.92; P=.3451).
  • In adjusted analysis, compared with nonusers, statin users had:
    • Nonsignificantly reduced risk for primary composite vascular outcome (HR, 0.84; P=.0811).
    • Significantly reduced risk for stroke alone (HR, 0.68; P=.0368).
  • Statin users had higher rates of myopathy (OR, 2.0; 95% CI, 1.1-3.7), sleep disorders (OR, 3.9; 95% CI, 2.3-6.6); were similar on rates of hepatitis, transaminitis, myositis/myalgia.

Study design

  • Canadian retrospective cohort study of 5718 cardiac patients aged >45 years with thorax, head, or neck cancer who received radiation therapy during 2000-2011.
  • 73% statin users: first prescription starting from 1 year before time zero (radiation exposure) to event/censure.
  • Main outcome: composite of cerebrovascular events (transient ischemic attack, fatal or nonfatal stroke) and cardiovascular events (fatal or nonfatal myocardial infarction).
  • Funding: None disclosed.

Limitations

  • Residual, unmeasured confounding.
  • Statin exposure ascertained from database.