Use of β-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and risk of breast cancer recurrence: a Danish nationwide prospective cohort study.
|Title||Use of β-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and risk of breast cancer recurrence: a Danish nationwide prospective cohort study.|
|Publication Type||Journal Article|
|Year of Publication||2013|
|Authors||Sørensen GVrelits, Ganz PA, Cole SW, Pedersen LA, Sørensen HToft, Cronin-Fenton DP, Garne JPeter, Christiansen PM, Lash TL, Ahern TP|
|Journal||J Clin Oncol|
|Date Published||2013 Jun 20|
|Keywords||Adrenergic beta-Antagonists, Adult, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Breast Neoplasms, Denmark, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Proportional Hazards Models, Prospective Studies, Registries, Risk Assessment, Risk Factors|
PURPOSE: To estimate associations between use of β-blockers, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers (ARBs) and breast cancer recurrence in a large Danish cohort.
PATIENTS AND METHODS: We enrolled 18,733 women diagnosed with nonmetastatic breast cancer between 1996 and 2003. Patient, treatment, and 10-year recurrence data were ascertained from the Danish Breast Cancer Cooperative Group registry. Prescription and medical histories were ascertained by linkage to the National Prescription Registry and Registry of Patients, respectively. β-Blocker exposure was defined in aggregate and according to solubility, receptor selectivity, and individual drugs. ACE inhibitor and ARB exposures were defined in aggregate. Recurrence associations were estimated with multivariable Cox regression models in which time-varying drug exposures were lagged by 1 year.
RESULTS: Compared with never users, users of any β-blocker had a lower recurrence hazard in unadjusted models (unadjusted hazard ratio [HR] = 0.91; 95% CI, 0.81 to 1.0) and a slightly higher recurrence hazard in adjusted models (adjusted HR = 1.3; 95% CI, 1.1 to 1.5). Associations were similar for exposures defined by receptor selectivity and solubility. Although most individual β-blockers showed no association with recurrence, metoprolol and sotalol were associated with increased recurrence rates (adjusted metoprolol HR = 1.5, 95% CI, 1.2 to 1.8; adjusted sotalol HR = 2.0, 95% CI, 0.99 to 4.0). ACE inhibitors were associated with a slightly increased recurrence hazard, whereas ARBs were not associated with recurrence (adjusted ACE inhibitor HR = 1.2, 95% CI, 0.97 to 1.4; adjusted ARBs HR = 1.1, 95% CI, 0.85 to 1.3).
CONCLUSION: Our data do not support the hypothesis that β-blockers attenuate breast cancer recurrence risk.
|Alternate Journal||J. Clin. Oncol.|
|PubMed Central ID||PMC3677839|
|Grant List||R01 CA118708 / CA / NCI NIH HHS / United States |
T32 CA09001-35 / CA / NCI NIH HHS / United States