Response to letters regarding article, “statins and the risk of cancer after heart transplantation”

We thank the authors Garbe, Suissa, and Vorlat for their interest in our study,1 and we would like to reply to the different issues raised in their letters. Dr Garbe outlined that a previous large randomized trial involving 20 536 patients with coronary artery disease, peripheral artery disease, or diabetes mellitus failed to demonstrate an improved cancer-free survival in patients who received 40 mg simvastatin and had an 11-year follow-up.2,3 However, there remain several methodological issues with this study. The mean follow-up in the original randomized trial was 5.3 years,3 and only inclusion of a nonrandomized post-trial observational time yielded a follow-up of 11 years. Importantly, 70% of patients were on statin therapy in both groups, the original statin and the original placebo group, 2 years …