Beta-blocker use and survival after pancreatic cancer surgery : A nationwide population-based cohort study
© 2023 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd..
PURPOSE: We examined the association between use of beta-blockers and survival in pancreatic cancer patients after curative-intent surgery.
METHODS: Using Danish healthcare registries, we conducted a population-based cohort study of all patients undergoing curative-intent surgery for pancreatic cancer in Denmark 1997-2021. We defined beta-blocker use according to exposure before surgery as current (≤90 days), recent (91-365 days), or former (366-730 days) use, requiring at least one filled prescription. Patients were followed from the date of surgery for up to 5 years. We used Cox regression to compute hazard ratios (HRs) of deaths with 95% confidence intervals (CIs), adjusting for age, sex, year of diagnosis, cardiovascular disease, diabetes, liver disease, alcohol, and smoking. We also conducted an active comparator analysis, where we used angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers as comparators instead of nonusers.
RESULTS: We included 2592 patients, of which 16.7% were beta-blocker users. Median survival for the entire population was 24.4 months. Beta-blocker use was associated with increased mortality (adjusted HR: 1.18; 95% CI: 1.04-1.34). This was evident in current (adjusted HR: 1.19; 95% CI: 1.02-1.38) and recent (adjusted HR: 1.29; 95% CI: 1.04-1.59) but not former (adjusted HR: 0.91; 95% CI: 0.64-1.43) users. In the active comparator analysis, the association between beta-blocker exposure and mortality attenuated slightly (adjusted HR: 1.12; 95% CI: 0.93-1.35).
CONCLUSIONS: We observed an association between beta-blocker use and increased mortality in patients operated for pancreatic cancer. Findings are likely explained by confounding by indication.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Pharmacoepidemiology and drug safety - 33(2024), 1 vom: 29. Jan., Seite e5726 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kirkegård, Jakob [VerfasserIn] |
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| Links: |
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| Themen: |
Adrenergic beta-Antagonists |
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| Anmerkungen: |
Date Completed 22.01.2024 Date Revised 22.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/pds.5726 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Date Revised 22.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. | ||
| 520 | |a PURPOSE: We examined the association between use of beta-blockers and survival in pancreatic cancer patients after curative-intent surgery | ||
| 520 | |a METHODS: Using Danish healthcare registries, we conducted a population-based cohort study of all patients undergoing curative-intent surgery for pancreatic cancer in Denmark 1997-2021. We defined beta-blocker use according to exposure before surgery as current (≤90 days), recent (91-365 days), or former (366-730 days) use, requiring at least one filled prescription. Patients were followed from the date of surgery for up to 5 years. We used Cox regression to compute hazard ratios (HRs) of deaths with 95% confidence intervals (CIs), adjusting for age, sex, year of diagnosis, cardiovascular disease, diabetes, liver disease, alcohol, and smoking. We also conducted an active comparator analysis, where we used angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers as comparators instead of nonusers | ||
| 520 | |a RESULTS: We included 2592 patients, of which 16.7% were beta-blocker users. Median survival for the entire population was 24.4 months. Beta-blocker use was associated with increased mortality (adjusted HR: 1.18; 95% CI: 1.04-1.34). This was evident in current (adjusted HR: 1.19; 95% CI: 1.02-1.38) and recent (adjusted HR: 1.29; 95% CI: 1.04-1.59) but not former (adjusted HR: 0.91; 95% CI: 0.64-1.43) users. In the active comparator analysis, the association between beta-blocker exposure and mortality attenuated slightly (adjusted HR: 1.12; 95% CI: 0.93-1.35) | ||
| 520 | |a CONCLUSIONS: We observed an association between beta-blocker use and increased mortality in patients operated for pancreatic cancer. Findings are likely explained by confounding by indication | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a beta-blockers | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a pancreatic cancer | |
| 650 | 4 | |a pharmacoepidemiology | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a survival | |
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| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 700 | 1 | |a Cronin-Fenton, Deirdre |e verfasserin |4 aut | |
| 700 | 1 | |a Lund, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Mortensen, Frank Viborg |e verfasserin |4 aut | |
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