STOP-CA
Statins TO Prevent the Cardiotoxicity From Anthracyclines
Paciente / Población Intervención / Exposición Comparación Desenlace
In 300 patients with lymphoma scheduled for anthracycline-based chemotherapy, atorvastatin 40 mg daily for 12 months reduced the proportion of patients with an ejection-fraction decline of at least 10 % to below 55 % compared with placebo.
N
300
Diseño
Double-blind, placebo-controlled RCT
Desenlace
Proportion with an absolute LVEF decline of ≥10 % to a final value below 55 % at 12 months
Relevancia
2
Resultado9 % vs 22 % (p=0.002; odds ratio for placebo 2.9; 95 % CI 1.4–6.4). Adjudicated heart failure 3 % vs 6 % (p=0.26; not significant).
Neilan TG, Quinaglia T, Onoue T, et al. JAMA. 2023;330(6):528-536. 10.1001/jama.2023.11887
Discusión y crítica
The endpoint is an echocardiographic surrogate; the trial was not powered for heart failure, and clinical heart failure did not differ between arms. It is the largest positive statin trial in cardio-oncology and provides the randomised basis for statin cardioprotection in high-risk patients receiving anthracyclines.