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Article: Statin associated lower cancer risk and related mortality in patients with heart failure

TitleStatin associated lower cancer risk and related mortality in patients with heart failure
Authors
KeywordsHeart failure
Cancer
Cardio-oncology
Statin
Prevention
Issue Date2021
PublisherOxford University Press. The Journal's web site is located at http://eurheartj.oxfordjournals.org/
Citation
European Heart Journal, 2021, v. 42 n. 32, p. 3049-3059 How to Cite?
AbstractAims: Patients with heart failure (HF) have an increased risk of incident cancer. Data relating to the association of statin use with cancer risk and cancer-related mortality among patients with HF are sparse. Methods and results: Using a previously validated territory-wide clinical information registry, statin use was ascertained among all eligible patients with HF (n = 87 102) from 2003 to 2015. Inverse probability of treatment weighting was used to balance baseline covariates between statin nonusers (n = 50 926) with statin users (n = 36 176). Competing risk regression with Cox proportional-hazard models was performed to estimate the risk of cancer and cancer-related mortality associated with statin use. Of all eligible subjects, the mean age was 76.5 ± 12.8 years, and 47.8% was male. Over a median follow-up of 4.1 years (interquartile range: 1.6–6.8), 11 052 (12.7%) were diagnosed with cancer. Statin use (vs. none) was associated with a 16% lower risk of cancer incidence [multivariable adjusted subdistribution hazard ratio (SHR) = 0.84; 95% confidence interval (CI), 0.80–0.89]. This inverse association with risk of cancer was duration dependent; as compared with short-term statin use (3 months to <2 years), the adjusted SHR was 0.99 (95% CI, 0.87–1.13) for 2 to <4 years of use, 0.82 (95% CI, 0.70–0.97) for 4 to <6 years of use, and 0.78 (95% CI, 0.65–0.93) for ≥6 years of use. Ten-year cancer-related mortality was 3.8% among statin users and 5.2% among nonusers (absolute risk difference, −1.4 percentage points [95% CI, −1.6% to −1.2%]; adjusted SHR = 0.74; 95% CI, 0.67–0.81). Conclusion: Our study suggests that statin use is associated with a significantly lower risk of incident cancer and cancer-related mortality in HF, an association that appears to be duration dependent.
Persistent Identifierhttp://hdl.handle.net/10722/305378
ISSN
2023 Impact Factor: 37.6
2023 SCImago Journal Rankings: 4.091
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorRen, QW-
dc.contributor.authorYu, SY-
dc.contributor.authorTeng, THK-
dc.contributor.authorLi, X-
dc.contributor.authorCheung, KS-
dc.contributor.authorWu, MZ-
dc.contributor.authorLi, HL-
dc.contributor.authorWong, PF-
dc.contributor.authorTse, HF-
dc.contributor.authorLam, CSP-
dc.contributor.authorYiu, KH-
dc.date.accessioned2021-10-20T10:08:34Z-
dc.date.available2021-10-20T10:08:34Z-
dc.date.issued2021-
dc.identifier.citationEuropean Heart Journal, 2021, v. 42 n. 32, p. 3049-3059-
dc.identifier.issn0195-668X-
dc.identifier.urihttp://hdl.handle.net/10722/305378-
dc.description.abstractAims: Patients with heart failure (HF) have an increased risk of incident cancer. Data relating to the association of statin use with cancer risk and cancer-related mortality among patients with HF are sparse. Methods and results: Using a previously validated territory-wide clinical information registry, statin use was ascertained among all eligible patients with HF (n = 87 102) from 2003 to 2015. Inverse probability of treatment weighting was used to balance baseline covariates between statin nonusers (n = 50 926) with statin users (n = 36 176). Competing risk regression with Cox proportional-hazard models was performed to estimate the risk of cancer and cancer-related mortality associated with statin use. Of all eligible subjects, the mean age was 76.5 ± 12.8 years, and 47.8% was male. Over a median follow-up of 4.1 years (interquartile range: 1.6–6.8), 11 052 (12.7%) were diagnosed with cancer. Statin use (vs. none) was associated with a 16% lower risk of cancer incidence [multivariable adjusted subdistribution hazard ratio (SHR) = 0.84; 95% confidence interval (CI), 0.80–0.89]. This inverse association with risk of cancer was duration dependent; as compared with short-term statin use (3 months to <2 years), the adjusted SHR was 0.99 (95% CI, 0.87–1.13) for 2 to <4 years of use, 0.82 (95% CI, 0.70–0.97) for 4 to <6 years of use, and 0.78 (95% CI, 0.65–0.93) for ≥6 years of use. Ten-year cancer-related mortality was 3.8% among statin users and 5.2% among nonusers (absolute risk difference, −1.4 percentage points [95% CI, −1.6% to −1.2%]; adjusted SHR = 0.74; 95% CI, 0.67–0.81). Conclusion: Our study suggests that statin use is associated with a significantly lower risk of incident cancer and cancer-related mortality in HF, an association that appears to be duration dependent.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://eurheartj.oxfordjournals.org/-
dc.relation.ispartofEuropean Heart Journal-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHeart failure-
dc.subjectCancer-
dc.subjectCardio-oncology-
dc.subjectStatin-
dc.subjectPrevention-
dc.titleStatin associated lower cancer risk and related mortality in patients with heart failure-
dc.typeArticle-
dc.identifier.emailLi, X: sxueli@hku.hk-
dc.identifier.emailCheung, KS: cks634@hku.hk-
dc.identifier.emailWong, PF: wongpf@hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.emailYiu, KH: khkyiu@hku.hk-
dc.identifier.authorityLi, X=rp02531-
dc.identifier.authorityCheung, KS=rp02532-
dc.identifier.authorityTse, HF=rp00428-
dc.identifier.authorityYiu, KH=rp01490-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1093/eurheartj/ehab325-
dc.identifier.pmid34157723-
dc.identifier.pmcidPMC8380061-
dc.identifier.scopuseid_2-s2.0-85114628956-
dc.identifier.hkuros326615-
dc.identifier.volume42-
dc.identifier.issue32-
dc.identifier.spage3049-
dc.identifier.epage3059-
dc.identifier.isiWOS:000693751800008-
dc.publisher.placeUnited Kingdom-

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