Use of Statins and the Risk of Death in Patients With Prostate Cancer

作者：Oriana Hoi Yun Yu, María Eberg, Serge Benayoun, Armen Garo Aprikian, Gerald Batist, Samy Suissa, Laurent Azoulay · 发表于：Journal of Clinical Oncology · 年份：2013 · DOI：10.1200/jco.2013.49.4757 · 被引用次数：662 · 研究领域：Cancer, Lipids, and Metabolism、Lipoproteins and Cardiovascular Health、Cancer, Stress, Anesthesia, and Immune Response

PURPOSE: To determine whether the use of statins after prostate cancer diagnosis is associated with a decreased risk of cancer-related mortality and all-cause mortality and to assess whether this association is modified by prediagnostic use of statins. PATIENTS AND METHODS: A cohort of 11,772 men newly diagnosed with nonmetastatic prostate cancer between April 1, 1998, and December 31, 2009, followed until October 1, 2012, was identified using a large population-based electronic database from the United Kingdom. Time-dependent Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs of mortality outcomes associated with postdiagnostic use of statins, lagged by 1 year to account for latency considerations and to minimize reverse causality, and considering effect modification by prediagnostic use of statins. RESULTS: During a mean follow-up time of 4.4 years (standard deviation, 2.9 years), 3,499 deaths occurred, including 1,791 from prostate cancer. Postdiagnostic use of statins was associated with a decreased risk of prostate cancer mortality (HR, 0.76; 95% CI, 0.66 to 0.88) and all-cause mortality (HR, 0.86; 95% CI, 0.78 to 0.95). These decreased risks of prostate cancer mortality and all-cause mortality were more pronounced in patients who also used statins before diagnosis (HR, 0.55; 95% CI, 0.41 to 0.74; and HR, 0.66; 95% CI, 0.53 to 0.81, respectively), with weaker effects in patients who initiated the treatment only after diagnosis...