Effect of statin treatment on the risk of cancer in patients with heart failure: A target trial emulation study

Chengsheng Ju, Wallis C. Y. Lau, Pinkie Chambers, Kenneth K. C. Man, Martin D. Forster, Isla S Mackenzie, Charlotte Manisty, Li Wei (Lead / Corresponding author)

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Abstract

PURPOSE: A recent observational study suggested statins could reduce cancer diagnosis in patients with heart failure (HF). The findings need to be validated using robust epidemiological methods. This study aimed to evaluate the effect of statin treatment on the risk of cancer in patients with HF.

METHODS: We conducted two target trial emulations using primary care data from IQVIA Medical Research Database-UK (2000 to 2019) with a clone-censor-weight design. The first emulated trial addressed the treatment initiation effect: initiating within 1 year versus not initiating a statin after the HF diagnosis. The second emulated trial addressed the cumulative exposure effect: continuing a statin for ≤3 years, 3-6 years, and >6 years after initiation. The study outcomes were any incident cancer and site-specific cancer diagnoses. Weighted pooled logistic regression models were used to estimate 10-year risk ratios (RR). 95% confidence intervals (CIs) were estimated using non-parametric bootstrapping.

RESULTS: The first emulated trial showed that, compared to no statin, statins did not reduce the cancer risk in patients with HF (RR, 1.05; 95% CI, 0.94-1.15). The second emulated trial showed that, compared to treatment ≤3 years, statins with longer durations did not reduce the cancer risk (3-6 years: RR, 0.94; 95% CI, 0.70-1.33. >6 years: RR, 0.97; 95% CI, 0.79-1.26). No significant risk difference was observed on any site-specific cancer diagnoses.

CONCLUSIONS: The results from the target trial emulations suggest that statin treatment is not associated with cancer risk in patients with HF.

Original languageEnglish
Article numbere5775
Number of pages12
JournalPharmacoepidemiology and Drug Safety
Volume33
Issue number3
Early online date7 Mar 2024
DOIs
Publication statusPublished - Mar 2024

Keywords

  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects
  • Neoplasms/epidemiology
  • Research Design
  • Heart Failure/epidemiology
  • Cognition
  • heart failure
  • statin
  • cancer
  • target trial emulation
  • causal inference

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Epidemiology

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