Statin Use After Diagnosis of Breast Cancer and Survival A Population-based Cohort Study
Statin Use After Diagnosis of Breast Cancer and Survival A Population-based Cohort Study
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DOI：
10.1097/ede.0000000000000189
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发表时间：
2015-01-01
期刊：
影响因子：
5.4
通讯作者：
Murray, Liam J.
中科院分区：
文献类型：
--
作者：
Cardwell, Chris R.;Hicks, Blanaid M.;Murray, Liam J.
背景：临床前研究表明，他汀类药物，特别是辛伐他汀，可以阻止乳腺癌细胞系和动物模型的生长。我们调查是否使用他汀类药物后，乳腺癌诊断降低乳腺癌的风险，或全因，死亡率在一个大的队列的乳腺癌patients.Methods：一个队列的17,880乳腺癌患者，新诊断的1998年和2009年之间，确定从英国癌症登记（从国家癌症数据库）。该队列与英国临床实践研究数据链（提供处方记录）和国家统计局死亡率数据（截至2013年）相关联，确定了3694例死亡，包括1469例乳腺癌死亡。使用时间依赖性考克斯回归模型计算他汀类药物使用者在乳腺癌诊断后乳腺癌特异性和全因死亡率的未校正和校正风险比（HR）。敏感性分析采用多重插补方法，倾向评分法和病例对照approach.Results：有一些证据表明，他汀类药物使用后，乳腺癌的诊断有降低死亡率由于乳腺癌和所有原因（完全调整HR = 0.84 [95%置信区间= 0.68-1.04]和0.84 [0.72-0.97]，分别）。这些协会更显着的辛伐他汀0.79（0.63-1.00）和0.81（0.70-0.95），分别：在这个大的人群为基础的乳腺癌队列，有一些证据表明，乳腺癌诊断后，他汀类药物使用者的死亡率降低。然而，这些关联在幅度上很弱，并且在一些敏感性分析中减弱。
Background: Preclinical studies have shown that statins, particularly simvastatin, can prevent growth in breast cancer cell lines and animal models. We investigated whether statins used after breast cancer diagnosis reduced the risk of breast cancer-specific, or all-cause, mortality in a large cohort of breast cancer patients.Methods: A cohort of 17,880 breast cancer patients, newly diagnosed between 1998 and 2009, was identified from English cancer registries (from the National Cancer Data Repository). This cohort was linked to the UK Clinical Practice Research Datalink, providing prescription records, and to the Office of National Statistics mortality data (up to 2013), identifying 3694 deaths, including 1469 deaths attributable to breast cancer. Unadjusted and adjusted hazard ratios (HRs) for breast cancer-specific, and all-cause, mortality in statin users after breast cancer diagnosis were calculated using time-dependent Cox regression models. Sensitivity analyses were conducted using multiple imputation methods, propensity score methods and a case-control approach.Results: There was some evidence that statin use after a diagnosis of breast cancer had reduced mortality due to breast cancer and all causes (fully adjusted HR = 0.84 [95% confidence interval = 0.68-1.04] and 0.84 [0.72-0.97], respectively). These associations were more marked for simvastatin 0.79 (0.63-1.00) and 0.81 (0.70-0.95), respectively.Conclusions: In this large population-based breast cancer cohort, there was some evidence of reduced mortality in statin users after breast cancer diagnosis. However, these associations were weak in magnitude and were attenuated in some sensitivity analyses.