Evidence map›Paper›PMID 37120736›Full record

Trial reportEuropean heart journal. Cardiovascular pharmacotherapy2023

Statins to prevent early cardiac dysfunction in cancer patients at increased cardiotoxicity risk receiving anthracyclines.

Paaladinesh Thavendiranathan, Christian Houbois, Thomas H Marwick, Tiffanie Kei, Sudipta Saha, Kyle Runeckles, Flora Huang, Tamar Shalmon, Kevin E Thorpe, Rossanna C Pezo and 11 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal. Cardiovascular pharmacotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03186404. Cited by 60 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 3 pooled it
20.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03186404 phase2unknown status

Randomized Double Blind Placebo Controlled Trial of Statins for the Primary pREvention of Heart Failure in Patients With Cancer Receiving Anthracycline Based Chemotherapy

Ran2018Enrolled112Registered outcomes8Posted comparisons0ConditionsCancer, Cardiotoxicity, Heart FailureArmsAtorvastatin, Placebo Oral Tablet
Open the trial in the graph
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 3 syntheses or guidelines pooled it, 95 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Risk-guided cardioprotection in cardio-oncology.Nature cardiovascular research · 2026
    Review
  6. Review
  7. Dyslipidaemias in cancer patients.European heart journal · 2026
    Review
  8. Article
  9. Role of Troponins in CardioOncology.Current treatment options in oncology · 2026
    Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Research Priorities and Future Directions in Cardio-Oncology.Current treatment options in oncology · 2026
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 5 institutions in 2 countries.

Paaladinesh ThavendiranathanDepartment of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-6497-1098
Christian HouboisDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Thomas H MarwickBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Melbourne, Victoria, Australia.
Tiffanie KeiDepartment of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Sudipta SahaRogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
Kyle RunecklesRogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
Flora HuangDepartment of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Tamar ShalmonDepartment of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Kevin E ThorpeDalla Lana School of Public Health, University of Toronto and Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Rossanna C PezoDepartment of Medicine, Division of Medical Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Anca PricaDepartment of Medicine, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
Dawn MazeDepartment of Medicine, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
Husam Abdel-QadirDepartment of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Kim A ConnellyKeenan Research Centre, Li Ka Shing Knowledge Institute, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Joyce ChanDivision of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Filio BilliaDivision of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-2824-1215
Coleen PowerDepartment of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Kate HannemanJoint Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Bernd J WinterspergerJoint Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Christine Brezden-MasleyDepartment of Medicine, Division of Medical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Eitan AmirDepartment of Medicine, Division of Medical Oncology, Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-3706-525X
University Health Network · CASt. Michael's Hospital · CASunnybrook Health Science Centre · CABaker Heart and Diabetes Institute · AUMount Sinai Hospital · CA

Funding

CIHR 147 814
6 · The paper itself

Abstract

BACKGROUND AND

aimsAnthracyclines can cause cancer therapy-related cardiac dysfunction (CTRCD). We aimed to assess whether statins prevent decline in left ventricular ejection fraction (LVEF) in anthracycline-treated patients at increased risk for CTRCD.

methodsIn this multicenter double-blinded, placebo-controlled trial, patients with cancer at increased risk of anthracycline-related CTRCD (per ASCO guidelines) were randomly assigned to atorvastatin 40 mg or placebo once-daily. Cardiovascular magnetic resonance (CMR) imaging was performed before and within 4 weeks after anthracyclines. Blood biomarkers were measured at every cycle. The primary outcome was post-anthracycline LVEF, adjusted for baseline. CTRCD was defined as a fall in LVEF by >10% to <53%. Secondary endpoints included left ventricular (LV) volumes, CTRCD, CMR tissue characterization, high sensitivity troponin I (hsTnI), and B-type natriuretic peptide (BNP).

resultsWe randomized 112 patients (56.9 ± 13.6 years, 87 female, and 73 with breast cancer): 54 to atorvastatin and 58 to placebo. Post-anthracycline CMR was performed 22 (13-27) days from last anthracycline dose. Post-anthracycline LVEF did not differ between the atorvastatin and placebo groups (57.3 ± 5.8% and 55.9 ± 7.4%, respectively) when adjusted for baseline LVEF (P = 0.34). There were no significant between-group differences in post-anthracycline LV end-diastolic (P = 0.20) or end-systolic volume (P = 0.12), CMR myocardial edema and/or fibrosis (P = 0.06-0.47), or peak hsTnI (P ≥ 0.99) and BNP (P = 0.23). CTRCD incidence was similar (4% versus 4%, P ≥ 0.99). There was no difference in adverse events.

conclusionsIn patients at increased risk of CTRCD, primary prevention with atorvastatin during anthracycline therapy did not ameliorate early LVEF decline, LV remodeling, CTRCD, change in serum cardiac biomarkers, or CMR myocardial tissue changes.

trial registrationNCT03186404.

Indexed as

Breast NeoplasmsHeart DiseasesHydroxymethylglutaryl-CoA Reductase InhibitorsAnthracyclinesAntibiotics, AntineoplasticAtorvastatinBiomarkersCardiotoxicityFemaleHumansStroke VolumeVentricular Function, LeftAnthracyclinesAntibiotics, AntineoplasticAtorvastatinBiomarkersHydroxymethylglutaryl-CoA Reductase InhibitorsAnthracyclineCardiotoxicityMagnetic resonance imagingPrimary preventionStatins

Identifiers

PMID37120736
PMCPMC10509566
OpenAlexW4367549649

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.