Statins and Risk of Cancer A Retrospective Cohort Analysis of 45,857 Matched Pairs From an Electronic Medical Records Database of 11 Million Adult Americans
Statins and Risk of Cancer A Retrospective Cohort Analysis of 45,857 Matched Pairs From an Electronic Medical Records Database of 11 Million Adult Americans
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DOI：
10.1016/j.jacc.2011.04.015
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发表时间：
2011-07-26
影响因子：
24
通讯作者：
DeMaria, Anthony N.
中科院分区：
文献类型：
--
作者：
Marelli, Claudio;Gunnarsson, Candace;DeMaria, Anthony N.
本研究的目的是通过至少3年的随访，确定癌症是否可归因于美国普通老年人使用他汀类药物。在美国，他汀类药物被广泛用于治疗血脂异常、动脉粥样硬化和降低心血管事件风险。关于他汀类药物与癌症之间关系的科学争论仍在继续，一些备受瞩目的研究显示出相互矛盾的结果。方法对使用和未使用他汀类药物的老年人癌症发病率进行回顾性队列分析。从1990年1月到2009年2月，从通用电气中心电子医疗记录数据库中提取了1100多万份可分析的患者记录。倾向匹配发现接受和未接受他汀类药物治疗的患者对他汀类药物的使用有相似的倾向。结果倾向评分法匹配了45,857对服用他汀类药物和未服用他汀类药物的患者。在数据库中的平均时间为8年，对伴侣的平均跟踪时间分别为4.6年和4.7年。匹配后，服用他汀类药物的患者的癌症发病率为11.37%，而未服用他汀类药物的匹配患者的癌症发病率为11.11%。多变量匹配Cox回归分析显示，风险比为1.04（95%可信区间：0.99 ~ 1.09）。任何癌症诊断的Kaplan-Meier曲线长达10年也显示服用他汀类药物的患者和未服用他汀类药物的患者没有差异。结论：这项对近46000对倾向配对的回顾性分析显示，与他汀类药物相关的癌症风险没有统计学上的显著增加。[J]中华医学会心脏科杂志，2011;58:563 - 571 . [C] 2011
Objectives The purpose of this study was to determine whether cancer can be attributed to statin use among a general population of older adults in the United States with at least 3 years of follow-up.Background Statins are widely prescribed drugs in the United States for the management of dyslipidemia, atherosclerosis, and cardiovascular event risk reduction. Unsettled scientific debate about the association of statins with cancer continues, with high-profile studies showing conflicting results.Methods A retrospective cohort analysis of the incidence of cancer in older adults who have and who have not used statins was performed. More than 11 million analyzable patient records from January 1990 through February 2009 were drawn from the General Electric Centricity electronic medical records database. Propensity matching found pairs of patients receiving and not receiving statin therapy who shared similar propensities for statin use.Results Propensity score methods matched 45,857 comparison pairs of patients taking a statin and patients not taking a statin. The average time in the database was 8 years, with pairs being followed for an average of 4.6 and 4.7 years. After matching, the incidence of cancer in patients taking a statin was 11.37% compared with 11.11% in matched patients not taking a statin. Multivariate-matched Cox regression analysis showed a nonsignificant hazard ratio of 1.04 (95% confidence interval: 0.99 to 1.09). Kaplan-Meier curves for diagnosis of any cancer up to 10 years also showed no difference for patients taking a statin and those not taking a statin.Conclusions This retrospective analysis of nearly 46,000 propensity-matched pairs demonstrated no statistically significant increased risk of cancer associated with statins. (J Am Coll Cardiol 2011; 58: 530-7) (C) 2011 by the American College of Cardiology Foundation