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J Am Coll Cardiol. 2011 Jul 26;58(5):530-7. doi: 10.1016/j.jacc.2011.04.015.
The purpose of this study was to determine whether cancer can be attributed to statin use among a general population of older adults in the United States with at least 3 years of follow-up.
Statins are widely prescribed drugs in the United States for the management of dyslipidemia, atherosclerosis, and cardiovascular event risk reduction. Unsettled scientific debate about the association of statins with cancer continues, with high-profile studies showing conflicting results.
A retrospective cohort analysis of the incidence of cancer in older adults who have and who have not used statins was performed. More than 11 million analyzable patient records from January 1990 through February 2009 were drawn from the General Electric Centricity electronic medical records database. Propensity matching found pairs of patients receiving and not receiving statin therapy who shared similar propensities for statin use.
Propensity score methods matched 45,857 comparison pairs of patients taking a statin and patients not taking a statin. The average time in the database was 8 years, with pairs being followed for an average of 4.6 and 4.7 years. After matching, the incidence of cancer in patients taking a statin was 11.37% compared with 11.11% in matched patients not taking a statin. Multivariate-matched Cox regression analysis showed a nonsignificant hazard ratio of 1.04 (95% confidence interval: 0.99 to 1.09). Kaplan-Meier curves for diagnosis of any cancer up to 10 years also showed no difference for patients taking a statin and those not taking a statin.
This retrospective analysis of nearly 46,000 propensity-matched pairs demonstrated no statistically significant increased risk of cancer associated with statins.
本研究旨在确定在至少随访 3 年的美国老年人群中，他汀类药物的使用是否与癌症有关。
他汀类药物在美国被广泛用于治疗血脂异常、动脉粥样硬化和降低心血管事件风险。关于他汀类药物与癌症之间关联的科学争议仍未解决，一些备受关注的研究结果相互矛盾。
对使用和未使用他汀类药物的老年患者癌症发病率进行回顾性队列分析。从 1990 年 1 月至 2009 年 2 月，从通用电气 Centricity 电子病历数据库中抽取了超过 1100 万份可分析的患者记录。采用倾向评分匹配方法找到了接受和未接受他汀类药物治疗的患者对他汀类药物使用的倾向相似的患者对。
倾向评分方法匹配了 45857 对服用他汀类药物和未服用他汀类药物的患者对。数据库中的平均时间为 8 年，患者平均随访 4.6 年和 4.7 年。匹配后，服用他汀类药物的患者癌症发病率为 11.37%，而匹配未服用他汀类药物的患者为 11.11%。多变量匹配 Cox 回归分析显示，风险比无统计学意义（1.04，95%置信区间：0.99 至 1.09）。Kaplan-Meier 曲线显示，在 10 年内诊断出任何癌症的患者中，服用他汀类药物的患者与未服用他汀类药物的患者之间也没有差异。
本研究对近 46000 对倾向匹配患者进行的回顾性分析表明，他汀类药物与癌症之间没有统计学上显著的相关性。
