Abstract 17717: Statin Use and the Risk of Vascular Events Among Cancer Patients After Radiotherapy to the Thorax, Head and Neck
Introduction: Radiation-induced atherosclerosis increases the incidence of cardiovascular and cerebrovascular events, independent of traditional vascular risk factors. Moreover patients with a cancer diagnosis may be likely to die from non-cancerous causes. Therefore it is important to know if cholesterol lowering drugs such as statins remain effective and essential therapies in this population.
Methods: We conducted a retrospective cohort study within a provincial linked database of elderly cardiac patients with thorax and head or neck cancer having undergone RT between 2000 and 2011. Patients were identified as statin and non-statin users. The primary outcome was the composite of cerebrovascular (stroke, transient ischemic attack, death due to stroke) or cardiovascular events (myocardial infarction or death due to myocardial infarction) occurring after the initiation of RT. Time-dependent Cox proportional hazard models analyses were performed.
Results: 6843 cancer patients were identified as having RT either to the thorax, head, or neck. 2102 were non statin users and 4741 were statin users. The crude event rate of vascular outcomes was 20.1% in non-statin users and 11.9% in Statin users (Hazard Ratio (HR) of 0.59 (95% CI 0.52-0.67, p<0.0001)). When adjusted for age, gender, prior history of stroke or myocardial infarction, we obtained a HR of 0.58 (95% CI 0.52-0.67, p<0.0001). The crude and adjusted HR for stroke alone were 0.61 (95% CI 0.46-0.8, p<0.0005) and 0.7 (95% CI 0.52-0.93, p<0.01) respectively. Results were not altered when statin therapy was used as a non-time dependent or as a time dependent variable.
Conclusion: In this large cohort of patients, statin therapy was associated with a 40% reduction in cardiovascular and cerebrovascular events. Prospective studies are required to further assess the role of statins for primary prevention of vascular events in this patient population.
Author Disclosures: J. Boulet: None. J. Pena: None. C. Freeman: None. C. lambert: None. T. Hijal: None. L. Nadeau: None. J. Brophy: None. N. Mousavi: None.
- © 2016 by American Heart Association, Inc.