Effect of a single dose of pre-operative pravastatin on C-reactive protein levels and neutrophil/lymphocyte ratio in patients undergoing mastectomy for breast cancer

Abstract

Introduction

In Mexico, breast cancer is the leading cause of death from malignant tumours in women over 25 years of age. Cancer patients present pro-inflammatory status which, added to the inflammatory response to surgery, worsens their prognosis, not only from a cardiovascular perspective but also by increasing the risk of tumour relapse and the onset of metastases. The objective of this study is to determine the role of pravastatin in the modulation of the systemic inflammatory response to surgical trauma by measuring C-reactive protein (CRP) levels and the neutrophil/lymphocyte ratio (NLR) in breast cancer patients undergoing radical mastectomy.

Methods

Randomised, single-blind, prospective clinical trial in breast cancer patients undergoing mastectomy, divided into two groups of 15 patients each. One of the groups was administered a pre-operative dose of pravastatin 20 mg and the other was not and the pre- and post-surgical inflammatory biomarker levels were measured. The numerical variables are expressed as means and with standard deviation. The comparison between groups was performed with Student's T-test.

Results

A total of 30 patients subject to radical mastectomy were enrolled in the study and divided into 2 groups. The mean age was 56.9 years in the control group and 53.4 years in the pravastatin group. It was found that the patients who received a 20 mg pre-op dose of pravastatin presented less CRP elevation, with a mean of 12.6 95% CI (8.34–16.9) vs 43.8 95% CI (34.3–53.37) in the control group, p 0.0000. Although the changes in the neutrophil/lymphocyte ratio were not statistically significant, p 0.2337, it was less elevated in the pravastatin group, with a mean of 3.57 95% CI (2.02–5.11) vs 7.17 95% CI (3–17.42) in the control group.

Conclusions

The pre-surgical administration of a single dose of pravastatin 20 mg significantly reduced inflammatory biomarker elevation, especially C-reactive protein, making it the ideal drug for routine use in patients undergoing radical mastectomy.