Abstract 4139494: Impact of Statins on Major Adverse Cardiovascular Events in Lung Cancer Patients Treated with Chest Radiation

Introduction: Chest radiation has been well-documented to predispose to major adverse cardiac events (MACE). However, preventing radiation-induced adverse cardiac events is still a research gap. There is limited data assessing the preventive value of statins in cardiovascular outcomes and mortality in chest radiation-treated cancer patients. This study aimed to bridge the knowledge gap. Methods: Retrospective propensity-matched analysis of lung cancer patients aged 30-75 years treated with chest radiation in the TriNetX database. Patients were divided into statin users (started within 3 months before or after radiation exposure) and non-users, and a 1:1 nearest-neighbor propensity-score matching was used to reduce cofounders. We calculated adjusted odds ratios (aOR) for outcomes and performed a 5-year follow-up Kaplan-Meier survival analysis using R software. Result: Both cohorts consisted of 448 patients each, and they were balanced in terms of demographics, comorbidities, and baseline medications (Table 1). The statin cohorts were followed for a median of 591 days, while the non-statin groups were followed for 549 days. At follow up, the incidence of MACE (a composite of all-cause mortality, heart failure, myocardial infarction, and cerebrovascular accident) was significantly higher in the statin cohort compared to the non-statin cohort (21.4% vs 0.4%, aOR: 7.36, 95%CI: 4.26-12.73, P<0.001). The survival probability was also significantly 6-fold lower in the statin cohort compared to the non-statin cohort (HR: 6.21, 95% CI (3.66 – 10.54), Log-Rank Test p<0.001) (fig 1). Conclusion: Among lung cancer patients, statin use around the time of chest radiation was associated with higher MACE and lower survival compared with non-statin users. Future prospective studies are needed to better assess the effects of statins on cardiovascular outcomes for patients with cancer receiving chest radiation.