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Final Program


Program-At-A-Glance

Rapid Fire Session

Session: Rapid Fire Session 2: Multi-Center Trials and Epidemiological Studies (Monitor 12)

Atorvastatin and Aortic Distensibility During Anthracycline-based Chemotherapy

Thursday, February 5, 2026
3:59 PM - 4:06 PM  
Location: Galapagos / Aruba / Ilhabela (2nd Lower Level)
Background: Impaired aortic distensibility (AD) is associated with cardiovascular morbidity and mortality. Anthracyclines reduce AD, leading to vascular dysfunction. However, there is no evidence-based intervention to preserve aortic distensibility among individuals receiving anthracyclines. We investigated whether atorvastatin mitigated the anthracycline-associated decrease in AD.

Methods: Newly diagnosed lymphoma patients scheduled to receive an anthracycline without a clinical indication for a statin were randomized to atorvastatin or placebo for 12 months. Cardiac MRI (CMR) was performed at baseline and 12 months in newly diagnosed lymphoma patients scheduled to receive an anthracycline. Ascending and descending aortic distensibilities were measured at the level of the right main pulmonary artery using a b-SSFP sequence. Post-hoc endpoints included a ≥1 standard deviation (SD, as the SD of the interval change in the whole cohort) decrease in ascending thoracic aortic (AAD) and descending thoracic aortic distensibility (DAD). Incident heart failure (HF) events were evaluated at 24 months. We used “x10−3 mmHg−1” as the unit of AD, referred to as “unit” below.

Results: Of 300 randomized participants, 168 (mean age 52±16 ys, 47% female) had paired AD data at baseline and 12-month follow-up. The baseline demographics, CV risk profile, and cumulative anthracycline dose were similar between the atorvastatin and placebo groups. At baseline, lower AAD (mean estimate -0.94; 95% confidence interval [CI]: -1.09, -0.80; for every 10-year, p< 0.001) and DAD (mean est. -0.69; 95% CI: -0.83, -0.54; for every 10-year, p< 0.001) were associated with older age.


A ³1 SD decrease (1.8 units) was seen among 7% with atorvastatin and 18% with placebo (odds ratio 2.90, 95% CI: 1.06 – 7.96, p=0.054) at 12 months.


There was no difference between the proportions of participants with a ³1 SD decrease (2.0 units) in DAD (14% for atorvastatin, 16% for placebo, p=0.67) at 12 months.


There were 12 (7%) incident heart failure (HF) events by 24 months after enrolment. There was no significant association between AAD and DAD values and HF events.

Conclusion: Up to 18% of anthracycline-treated patients experienced a ³1 SD drop in thoracic AAD over 12 months. At 12 months, the proportion of participants with a significant decline in AAD with atorvastatin was 7%. Although the difference did not reach statistical significance, the findings suggest a potential protective effect of atorvastatin on AAD, and further research is warranted.

Comparison of Atorvastatin and Placebo Groups at Baseline and 12-month Follow-up - Aortic Distensibility



























Ascending Aorta Distensibility (AAD)


 


Atorvastatin

n=88


Placebon=80


p


Baseline (10−3 mmHg−1)


Mean (±SD)


2.8 (±2.0)


3.5 (±2.3)


0.032


12 months (10−3 mmHg−1)


Mean (±SD)


3.1 (±2.2)


3.4 (±2.1)


0.22


Interval Change (10−3 mmHg−1)


Mean (±SD)


0.3 (±1.7)


-0.1 (±2.0)


0.26


≥1 SD (1.8 unit) Decrease (n, %)


Yes


6 (7)


14 (18)


0.054


No


71 (93)


66 (82)


Descending Aorta Distensibility (DAD)


 


Atorvastatin

n=88


Placebon=80


p


Baseline (10−3 mmHg−1)


Mean (±SD)


3.3 (±1.9)


3.6 (±1.8)


0.24


12 months (10−3 mmHg−1)


Mean (±SD)


3.4 (±1.9)


3.5 (±1.9)


0.59


Interval Change (10−3 mmHg−1)


Mean (±SD)


0.1 (±2.1)


-0.1 (±1.8)


0.76


≥1 SD (2.0 unit) Decrease (n, %)


Yes


12 (14)


13 (16)


0.67


No


76 (86)


67 (84)



Graphical Abstract - Summary Figure