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使用他汀类药物与美国老年癌症幸存者死亡结局的关系:一项全国性队列研究。

Association between statin usage and mortality outcomes in aging U.S. cancer survivors: a nationwide cohort study.

机构信息

Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, China.

Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.

出版信息

Aging Clin Exp Res. 2024 Oct 5;36(1):200. doi: 10.1007/s40520-024-02851-2.

Abstract

BACKGROUND

The population of Aging cancer survivors in the United States has surged to over 16.9 million. Research on the relationship between statin usage and post-cancer survival rates remains limited.

AIMS

This study aims to investigate the association between statin use and various causes of mortality among aging cancer survivors.

METHODS

We analyzed NHANES data from 1999 to 2018, Statin usage, both hydrophilic and lipophilic, was derived from NHANES prescription records. We utilized Cox proportional hazards models to associate statin utilization with mortality, differentiating causes of death according to statin type and patterns of use.

RESULTS

Within a cohort of 2,968 participants, statin usage was categorized into non-users (1,738), hydrophilic statin users (216), and lipophilic statin users (982). Compared to those who did not use statins, individuals prescribed hydrophilic statins did not show a reduced risk of all-cause mortality (adjusted hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.72-1.41; P = 0.960), as outlined in Model 3. In contrast, the group receiving lipophilic statins exhibited a notable decrease in all-cause mortality risk (adjusted HR, 0.77; P = 0.003). Nonetheless, both hydrophilic and lipophilic statins were effective in diminishing the risk associated with cancer from its onset until death, with hydrophilic statins showing a greater level of efficacy.

DISCUSSION

The potential of statins to reduce cancer-related mortality may provide avenues for targeted clinical interventions and management strategies.

CONCLUSIONS

Our study reveals that the use of lipophilic statins is significantly associated with lower all-cause and cancer-cause mortality risks among aging cancer survivors.

摘要

背景

美国老年癌症幸存者的人数激增至 1690 多万。关于他汀类药物使用与癌症后生存率之间关系的研究仍然有限。

目的

本研究旨在调查他汀类药物使用与老年癌症幸存者各种死因之间的关系。

方法

我们分析了 1999 年至 2018 年的 NHANES 数据,亲水性和疏水性他汀类药物的使用均来自 NHANES 处方记录。我们利用 Cox 比例风险模型将他汀类药物的使用与死亡率相关联,根据他汀类药物的类型和使用模式区分死因。

结果

在 2968 名参与者的队列中,他汀类药物的使用分为非使用者(1738 人)、亲水性他汀使用者(216 人)和疏水性他汀使用者(982 人)。与未使用他汀类药物的人相比,服用亲水性他汀类药物的人全因死亡率没有降低的风险(调整后的危险比 [HR] 1.01;95%置信区间 [CI] 0.72-1.41;P=0.960),如模型 3 所述。相比之下,服用疏水性他汀类药物的患者全因死亡率显著降低(调整后的 HR,0.77;P=0.003)。然而,亲水性和疏水性他汀类药物都能有效降低癌症发病至死亡的风险,亲水性他汀类药物的效果更大。

讨论

他汀类药物降低癌症相关死亡率的潜力为靶向临床干预和管理策略提供了途径。

结论

本研究表明,在老年癌症幸存者中,疏水性他汀类药物的使用与全因和癌症相关死亡率的降低显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39ba/11458640/cd7485e3c6a0/40520_2024_2851_Fig1_HTML.jpg

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