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

被引:60
作者
Marelli, Claudio [1 ,2 ]
Gunnarsson, Candace [1 ]
Ross, Susan [1 ]
Haas, Sara [1 ]
Stroup, Donna F. [1 ]
Cload, Paul [2 ]
Clopton, Paul [3 ]
DeMaria, Anthony N. [4 ]
机构
[1] S2 Stat Solutions Inc, Cincinnati, OH 45241 USA
[2] GE Healthcare, Chalfont St Giles, Bucks, England
[3] Vet Adm San Diego Healthcare Syst, San Diego, CA USA
[4] Univ Calif San Diego, San Diego, CA 92103 USA
关键词
cancer; drug; risk; safety; statins; LOW-DENSITY-LIPOPROTEIN; SECONDARY DATA SOURCES; SERUM-CHOLESTEROL; METAANALYSIS; REDUCTION; EZETIMIBE; MORTALITY; EFFICACY; THERAPY; SAFETY;
D O I
10.1016/j.jacc.2011.04.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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
引用
收藏
页码:530 / 537
页数:8
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