Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy.

Lack of effect of lowering LDL cholesterol on cancer: meta-analysis of individual data from 175,000 people in 27 randomised trials of statin therapy.
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DOI:
10.1371/journal.pone.0029849
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发表时间:
2012
期刊:
影响因子:
3.7
通讯作者:
Baigent C
Baigent C
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Cholesterol Treatment Trialists' (CTT) Collaboration;Emberson JR;Kearney PM;Blackwell L;Newman C;Reith C;Bhala N;Holland L;Peto R;Keech A;Collins R;Simes J;Baigent C

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他汀类药物治疗可降低血管闭塞事件的风险,但对癌症的潜在影响仍存在不确定性。我们试图利用 27 项大规模他汀类药物试验中 175,000 名患者的个体患者记录,详细评估他汀类药物降低 LDL 胆固醇 (LDL-C) 对癌症的影响。获得了 22 项他汀类药物与对照随机试验(中位持续时间 4.8 年)中 134,537 名参与者的个人记录,以及 5 项强化与低强度他汀类药物治疗试验(中位持续时间 5.1 年)中 39,612 名参与者的个人记录。在他汀类药物与对照试验中,用他汀类药物降低 LDL-C 大约 5 年对新诊断的癌症或此类癌症的死亡没有影响(癌症发病率:3755 [每年 1.4% [py]] 对比 3738 [1.4% py],RR 1.00 [95% CI 0.96-1.05];癌症死亡率:1365 [0.5% py] 对比第1358章 [0.5% py],RR 1.00 [95% CI 0.93–1.08])或在更多与更少他汀类药物的试验中(癌症发病率:1466 [1.6% py] vs 1472 [1.6% py],RR 1.00 [95% CI 0.93–1.07];癌症死亡率:447 [0.5% py] vs 481 [0.5% 吡啶],RR 0.93 [95% CI 0.82–1.06])。此外,没有证据表明,随着治疗年限的增加,对于任何单独的他汀类药物或任何给定的亚组,用他汀类药物治疗降低 LDL-C 对 23 个单独类别中的任何一个部位的癌症发病率或死亡率有任何影响。特别是,在低基线 LDL-C (<2 mmol/L) 的个体中,没有证据表明进一步降低 LDL-C(从约 1.7 至 1.3 mmol/L)会增加癌症风险(381 例 [1.6% py] 对比 408 例 [1.7% py];RR 0.92 [99% CI 0.76–1.10])。在 27 项随机试验中,平均五年的他汀类药物治疗对任何类型癌症(或所有癌症的总和)的发病率或死亡率没有影响。
Statin therapy reduces the risk of occlusive vascular events, but uncertainty remains about potential effects on cancer. We sought to provide a detailed assessment of any effects on cancer of lowering LDL cholesterol (LDL-C) with a statin using individual patient records from 175,000 patients in 27 large-scale statin trials. Individual records of 134,537 participants in 22 randomised trials of statin versus control (median duration 4.8 years) and 39,612 participants in 5 trials of more intensive versus less intensive statin therapy (median duration 5.1 years) were obtained. Reducing LDL-C with a statin for about 5 years had no effect on newly diagnosed cancer or on death from such cancers in either the trials of statin versus control (cancer incidence: 3755 [1.4% per year [py]] versus 3738 [1.4% py], RR 1.00 [95% CI 0.96-1.05]; cancer mortality: 1365 [0.5% py] versus 1358 [0.5% py], RR 1.00 [95% CI 0.93–1.08]) or in the trials of more versus less statin (cancer incidence: 1466 [1.6% py] vs 1472 [1.6% py], RR 1.00 [95% CI 0.93–1.07]; cancer mortality: 447 [0.5% py] versus 481 [0.5% py], RR 0.93 [95% CI 0.82–1.06]). Moreover, there was no evidence of any effect of reducing LDL-C with statin therapy on cancer incidence or mortality at any of 23 individual categories of sites, with increasing years of treatment, for any individual statin, or in any given subgroup. In particular, among individuals with low baseline LDL-C (<2 mmol/L), there was no evidence that further LDL-C reduction (from about 1.7 to 1.3 mmol/L) increased cancer risk (381 [1.6% py] versus 408 [1.7% py]; RR 0.92 [99% CI 0.76–1.10]). In 27 randomised trials, a median of five years of statin therapy had no effect on the incidence of, or mortality from, any type of cancer (or the aggregate of all cancer).
DOI: 10.1016/s0140-6736(10)60310-8
发表时间: 2010-11-13
期刊: LANCET
影响因子: 168.9
作者:
Armitage, Jane;Bowman, Louise;Wallendszus, Karl;Bulbulia, Richard;Rahimi, Kazem;Haynes, Richard;Parish, Sarah;Peto, Richard;Collins, Rory;Meade, T.;Sleight, P.;Collins, R.;Armitage, J.;Bowman, L.;Parish, S.;Peto, R.;Barton, J.;Bray, C.;Wincott, E.;Dayanandan, R.;Clarke, R.;Graham, I.;Simpson, D.;Warlow, C.;Wilken, D.;Tobert, J.;Mushner, T.;Doll, R.;Wilhelmsen, L.;Fox, K.;Hill, C.;Sandercock, P.;Webster, J.;Henderson, J.;Nixon, A.;Lackie, S.;Thompson, J.;Brown, M.;Blackwood, S.;Morgan, M.;Rhoden, W.;Saeed, B.;Houghton, M.;Nicholson, A.;Simpson, C.;Hoburn, B.;Cooper, I.;Gallivan, A.;Pickerell, E.;Hancock, J.;Watkinson, J.;Ryder, B.;Jones, S.;Burbridge, W.;Kitchen, M.;Leary, H. O.;Verow, C.;Meynell, L.;Rollinson, L.;Bain, S.;Jones, A.;Jewkes, C.;Russon, C.;Bateson, M.;Gill, P.;Nicol, J.;Bayly, G.;Stansbie, D.;Andrews, G.;Halestrap, M.;Meredith, J.;Best, R.;Appleyard, D.;Briggs, R.;Wareing, H.;Holmes, K.;Holt, J.;Kenyon, M.;White, C.;Khalifa, M.;Newton, D.;Wass, A.;Watkinson, R.;Creamer, J.;Anderson, S.;Bethell, A.;Butler, C.;Castro, K.;Washington, M.;Weston, M.;Cleaver, K.;Machin, J.;Wray, R.;Sinclair, J.;Van Aalst, A.;Been, M.;Mattu, R.;Bates, D.;Burke, A.;Gill, L.;Walton, E.;Cowley, M.;Robson, H.;Graham, A.;Rose, G.;Kerr, M.;Mallinson, J.;Peascod, B.;Donnelly, R.;Kalk, J.;Scott, A.;Gibson, T.;Hannah, J.;Henshaw, L.;Margetts, M.;Pearson, N.;Frost, S.;Murray, S.;Marshall, A.;Went, J.;Inman, A.;Simmonds, J.;Teasdale, A.;Kemp, T.;Roberts, G.;Kooner, J.;Cahill, S.;Lloyd, M.;Molloy, O.;Wigley, J.;Galvin, M.;Wilder, C.;Lindley, R.;Shaw, S.;Swainson, C.;Hillis, L.;Johnston, J.;Johnstone, A.;Miller, D.;Kennedy, M.;Mushahwar, S.;Savage, M.;Appleyard, D.;Ayer, G.;Schofield, J.;Greenhalgh, S.;Parks, J.;Speak, S.;Coulson, C.;Papouchado, M.;Carpenter, R.;Wisby, J.;Cobbe, S.;Campbell, C.;Hunter, J.;Young, H.;Gallacher, M.;Lindsay, D.;Halliday, A.;Godfrey, S.;Donahoo, L. 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Elson;Verow, C.;Burke, R. Lambley;Lloyd, C.;Dhawan, J.;John, J.;Bramley, D.;Catchpole, A.;Colecchia, A.;Gray, C.;LeQuelenec, M.;Remington, D.;Wiseman, J.;Gray, C.;Anderson, P.;Woolass, R.;Thomas, P.;Weston, C.;Guy, F.;Lynch, J.;Thomas, R.;Coates, S.;Gait, M.;Waller, D.;Elkins, K.;Franklin, M.;Moore, L.;Signy, M.;Chilton, R.;Joyce, E.;Wrapson, C.;Wiltshire, C.;Lewis, P.;Curtis, J.;Toole, J. O.;Scanlon, S.;Carey, C.;Dobson, L.;Gould, M.;Mansfield, H.;Ranson, G.;Rodaway, M.;Germon, J.;Cockcroft, J.;McDowell, I.;Field, R.;Whiting, J.;Dennison, C.;Roberts, D.;Cooper, M.;Davies, C.;Fitton, J.;Hutt, L.;Radford, L.;Ward, L.;Williamson, M.;McAlpine, H.;Dougall, H.;Robertson, L.;Scott, L.;Young, H.;Humphrey, P.;Saminaden, S.;Watling, D.;Davies, J.;Owen, L.;Clements, M.;Walker, E.;Atkins, E.;Lindley, R.;Shaw, T.;Swainson, C.;Webb, D.;MacCallum, H.;Markie, D.;Melville, V.;Adamson, L.;Johnston, A.;Polukord, E.;Rudden, M.;Hogan, J.;Lie, F.;Badger, V.;Duffy, S.;Mitchell, C.;MacQueen, E.;Baxter, R.;Campbell, S.;McDonald, L.;Wood, H.;Munro, A.;Pycock, C.;Cadwell, J.;Doughty, A.;Harvey, M.;Price, S.;Aldersley, M.;Lock, S.;Pendrey, P.;Barton, J.;Bray, C.;Dayanandan, R.;Wmcott, E.;Achiri, P.;Anderson, C.;Benham, J.;Bojowsky, H.;Boller, I.;Booker, V.;Brewer, A.;Brindley, G.;Cobb, L.;Collett, A.;Corbett, M.;Crowther, J.;Pour, S. Danesh;Edmunds, K.;Fortun, A.;Grimsey, T.;Harwood, C.;Hope, C.;Jones, R.;Jones, S.;Kidney, K.;King, M.;Knight, S.;Lang, H.;Madgwick, Z.;Marsden, C.;Matthews, C.;Matthewson, M.;Miller, J.;Moss, B.;Mostefai, Y.;Murphy, K.;Naughten, A.;Pickworth, S.;Radley, A.;Southren, S.;Sutherland, S.;Tong, R.;Turakani, M.;Umbrath, M.;Armitage, J.;Baigent, C.;Bowman, L.;Bulbulia, R.;Chen, Z.;Clarke, R.;Collins, R.;Dunachie, S.;Dasgupta, T.;Haynes, R.;Landray, M.;Mafham, M.;Majoni, W.;Murray, C.;Naessens, K.;Porter, T.;Rahimi, K.;Reith, C.;Clarke, M. 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通讯作者: Walton, E.
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影响因子: 120.7
作者:
Pedersen, TR;Faergeman, O;Tsai, J
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DOI: 10.1200/jco.2007.10.8936
发表时间: 2007-08-10
影响因子: 45.3
作者:
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通讯作者: Sitaras, Nikolaos M.
DOI: 10.1185/030079902125000787
发表时间: 2002-01-01
影响因子: 2.3
作者:
Athyros, VG;Papageorgiou, AA;Kontopoulos, AG
通讯作者: Kontopoulos, AG
DOI: 10.1001/jama.292.11.1307
发表时间: 2004-09-15
影响因子: 120.7
作者:
de Lemos, JA;Blazing, MA;Braunwald, E
通讯作者: Braunwald, E