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Table 5 Sensitivity analyses for association between ACEIs and ARBS and cancer specific mortality in colorectal cancer patients

From: Drugs affecting the renin-angiotensin system and survival from cancer: a population based study of breast, colorectal and prostate cancer patient cohorts

 

Cancer specific deaths number

Controls number

OR (95% CI)

P

OR (95% CI)

P

   

ACEI user versus non user

 

ARB user versus non user

 

Colorectal cancer

  

Main analysis: diagnosis to six months prior to deatha

1,093

5,231

0.76 (0.62, 0.93)

0.01

0.80 (0.59, 1.09)

0.16

Diagnosis to one year prior to deathb

869

4,152

0.83 (0.67, 1.03)

0.10

0.89 (0.64, 1.25)

0.51

Restricted to users of any antihypertensive medicationc prior to cancer diagnosisd

427

1,934

0.83 (0.65, 1.07)

0.15

0.90 (0.63, 1.27)

0.54

Comparison group restricted to users of any antihypertensive in exposure periodc

596

1,845

0.75 (0.61, 0.92)

0.01

0.80 (0.59, 1.10)

0.16

Additionally adjusting for other antihypertensivese

1,093

5,231

0.75 (0.61, 0.92)

0.01

0.80 (0.59, 1.09)

0.16

≥730 DDDs versus 0 DDDs (non-user)

1,093

5,231

0.73 (0.62, 1.00)

0.03

0.93 (0.64, 1.36)

0.72

Stage 1 and 2f

328

1,483

0.54 (0.38, 0.77)

0.001

0.80 (0.47, 1.37)

0.41

Stage 3 and 4f

740

3,185

0.86 (0.68, 1.10)

0.23

1.05 (0.72, 1.55)

0.79

Colon

649

3,134

0.84 (0.64, 1.09)

0.19

0.77 (0.52, 1.15)

0.21

Rectal

444

2,097

0.67 (0.49, 0.92)

0.01

0.91 (0.56, 1.50)

0.72

Males

638

3,078

0.80 (0.62, 1.03)

0.08

0.93 (0.62, 1.41)

0.74

Females

455

2,153

0.70 (0.49, 0.98)

0.04

0.64 (0.40, 1.03)

0.06

Pre-diagnostic useg

1,641

7,815

1.06 (0.89, 1.27)

0.51

0.86 (0.62, 1.18)

0.35

Time varying covariate analysish

1,109

2,559

    

≥1 DDDs versus 0 DDDs (non-user)

  

0.81 (0.69, 0.96)

0.01

0.86 (0.66, 1.12)

0.26

1 to365 DDDs versus 0 DDDs (non-user)

  

0.76 (0.59, 0.97)

0.03

0.64 (0.40, 1.03)

0.07

≥365 DDDs versus 0 DDDs (non-user)

  

0.85 (0.69, 1.03)

0.10

1.00 (0.73, 1.38)

0.99

≥1 DDDs versus 0 DDDs (non-user) in stage 1 and 2 patients

  

0.62 (0.46, 0.84)

0.002

0.65 (0.41, 1.05)

0.08

≥1 DDDs versus 0 DDDs (non-user) in stage 3 and 4 patients

  

0.91 (0.74, 1.10)

0.33

0.97 (0.70, 1.34)

0.83

  1. aExcept where otherwise stated analysis investigates medications from diagnosis to six months prior to death/index date and models include surgery (within six months of diagnosis), chemotherapy (within six months), radiotherapy (within six months), low dose aspirin (during exposure period), statins (during exposure period), comorbidities (pre-diagnosis or during exposure period, including myocardial infarction, cerebrovascular disease, congestive heart disease, chronic pulmonary disease, peripheral vascular disease, renal disease, peptic ulcer disease and diabetes), smoking (pre-diagnosis, with missing included as a category) and stage. bRestricted to individuals surviving more than 1.5 years. cAntihypertensive medications include beta-blockers, diuretics, vasodilator antihypertensive drugs, centrally acting antihypertensive drugs, alpha-adrenoceptor blocking drugs, ACEIs, ARBs, renin inhibitors and calcium channel blockers. dRestricted to individuals with >1 year of records prior to cancer diagnosis and pre-diagnostic use considered antihypertensive use in that year, excluding deaths in the year after cancer diagnosis. eModels include all variables in a and additionally include calcium channel blockers, diuretics and beta-blockers. fStratified analyses were conducted after re-matching controls to cases within strata, due to non-availability of matches overall numbers in subgroups may not be identical to numbers presented in Table 1. gRestricted to individuals with >1 year of records prior to cancer diagnosis and pre-diagnostic use considered ACEI/ARB use in that year, not excluding deaths in the year after cancer diagnosis. hReported estimates are adjusted hazard ratios and 95% CI, model contains age at diagnosis, year of diagnosis, gender, site (colon or rectum), surgery (within six months of diagnosis), chemotherapy (within six months), radiotherapy (within six months), statins (during exposure period as a time varying covariate), comorbidities (pre-diagnosis including myocardial infarction, cerebrovascular disease, congestive heart disease, chronic pulmonary disease, peripheral vascular disease, renal disease, peptic ulcer disease and diabetes) and stage. ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin II receptor blockers; CI, confidence interval; DDDs, daily defined doses; OR, odds ratio.
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BMC Medicine

ISSN: 1741-7015

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