Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study
Abstract Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are used in treating cardiovascular diseases. Previous studies indicated that ACEIs/ARBs may benefit cancer patients by inhibiting tumor angiogenesis and proliferation. The effect of ACEIs/A...
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| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-09513-4 |
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| author | Po-Chih Li Ru-Yu Huang Yu-Chien Yang Kun-Pin Hsieh Yi-Hsin Yang |
| author_facet | Po-Chih Li Ru-Yu Huang Yu-Chien Yang Kun-Pin Hsieh Yi-Hsin Yang |
| author_sort | Po-Chih Li |
| collection | DOAJ |
| description | Abstract Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are used in treating cardiovascular diseases. Previous studies indicated that ACEIs/ARBs may benefit cancer patients by inhibiting tumor angiogenesis and proliferation. The effect of ACEIs/ARBs on cancer survival in esophageal and gastric cancer is still unclear. This study is to investigate the association between ACEIs/ARBs usage and esophageal and gastric cancer prognosis. Methods This retrospective cohort study identified esophageal and gastric cancer patients during 2008–2016 from the Taiwan Cancer Registry, and obtained medication usage and follow-up information from the National Health Insurance Research Database and Death Registry. Analysis groups were defined as ACEIs/ARBs user or non-user based on the usage of ACEIs/ARBs within the 6 months after cancer diagnosis. The stabilized inverse probability of treatment weighting using propensity scores was applied to balance covariates between study groups. We also used Kaplan-Meier estimates and Cox regression to compare survival outcome and estimate hazard ratios (HRs). Results We identified 14,463 and 21,483 newly-diagnosed esophageal and gastric cancer patients during 2008–2016. ACEIs/ARBs users were associated with lower risk of cancer-specific mortality, although only significantly in gastric cancer (gastric: adjusted HR = 0.87, 95% CI = 0.78–0.97; esophageal: adjusted HR =0.88, 95% CI = 0.76–1.02). A better survival outcome was observed among patients who received higher cumulative defined daily dose of ACEIs/ARBs. Conclusions We found that using ACEIs/ARBs after cancer diagnosis were associated with lower risk of mortality. Our results add to the knowledge of the benefit of ACEIs/ARBs against mortality in individuals with esophageal/gastric cancer patients with hypertension. |
| first_indexed | 2024-12-10T13:35:05Z |
| format | Article |
| id | doaj.art-bbfee3a3f661403b8d42b9ee762bb356 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-10T13:35:05Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-bbfee3a3f661403b8d42b9ee762bb3562022-12-22T01:46:51ZengBMCBMC Cancer1471-24072022-04-0122111410.1186/s12885-022-09513-4Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world studyPo-Chih Li0Ru-Yu Huang1Yu-Chien Yang2Kun-Pin Hsieh3Yi-Hsin Yang4School of Pharmacy, College of Pharmacy, Kaohsiung Medical UniversityNational Institute of Cancer Research, National Health Research InstitutesSchool of Pharmacy, College of Pharmacy, Kaohsiung Medical UniversitySchool of Pharmacy, College of Pharmacy, Kaohsiung Medical UniversitySchool of Pharmacy, College of Pharmacy, Kaohsiung Medical UniversityAbstract Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are used in treating cardiovascular diseases. Previous studies indicated that ACEIs/ARBs may benefit cancer patients by inhibiting tumor angiogenesis and proliferation. The effect of ACEIs/ARBs on cancer survival in esophageal and gastric cancer is still unclear. This study is to investigate the association between ACEIs/ARBs usage and esophageal and gastric cancer prognosis. Methods This retrospective cohort study identified esophageal and gastric cancer patients during 2008–2016 from the Taiwan Cancer Registry, and obtained medication usage and follow-up information from the National Health Insurance Research Database and Death Registry. Analysis groups were defined as ACEIs/ARBs user or non-user based on the usage of ACEIs/ARBs within the 6 months after cancer diagnosis. The stabilized inverse probability of treatment weighting using propensity scores was applied to balance covariates between study groups. We also used Kaplan-Meier estimates and Cox regression to compare survival outcome and estimate hazard ratios (HRs). Results We identified 14,463 and 21,483 newly-diagnosed esophageal and gastric cancer patients during 2008–2016. ACEIs/ARBs users were associated with lower risk of cancer-specific mortality, although only significantly in gastric cancer (gastric: adjusted HR = 0.87, 95% CI = 0.78–0.97; esophageal: adjusted HR =0.88, 95% CI = 0.76–1.02). A better survival outcome was observed among patients who received higher cumulative defined daily dose of ACEIs/ARBs. Conclusions We found that using ACEIs/ARBs after cancer diagnosis were associated with lower risk of mortality. Our results add to the knowledge of the benefit of ACEIs/ARBs against mortality in individuals with esophageal/gastric cancer patients with hypertension.https://doi.org/10.1186/s12885-022-09513-4Esophageal cancerGastric cancerAngiotensin-converting enzyme inhibitors (ACEIs)Angiotensin receptor blockers (ARBs)EpidemiologySurvival analysis |
| spellingShingle | Po-Chih Li Ru-Yu Huang Yu-Chien Yang Kun-Pin Hsieh Yi-Hsin Yang Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study BMC Cancer Esophageal cancer Gastric cancer Angiotensin-converting enzyme inhibitors (ACEIs) Angiotensin receptor blockers (ARBs) Epidemiology Survival analysis |
| title | Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study |
| title_full | Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study |
| title_fullStr | Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study |
| title_full_unstemmed | Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study |
| title_short | Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study |
| title_sort | prognostic impact of angiotensin converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension a real world study |
| topic | Esophageal cancer Gastric cancer Angiotensin-converting enzyme inhibitors (ACEIs) Angiotensin receptor blockers (ARBs) Epidemiology Survival analysis |
| url | https://doi.org/10.1186/s12885-022-09513-4 |
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