Key result
Ever use of cardiac glycosides was not associated with an increased risk of lung cancer compared to never use (RR 1.09).
Why the study?
Does the use of cardiac glycosides increase the risk of lung cancer in patients with heart failure or supra-ventricular arrhythmia?
Case-Control (n=129,002)
Yes
Does the use of cardiac glycosides increase the risk of lung cancer in patients with heart failure or supra-ventricular arrhythmia?
In a large population-based cohort, the use of cardiac glycosides was not associated with an increased risk of lung cancer, refuting previous concerns.
Answers are grounded in this paper and cite their sources.
Supports no lung cancer risk increase with cardiac glycosides; leaves open prospective confirmation.
BACKGROUND: Two studies have reported statistically significant associations between the use of cardiac glycosides (CGs) and an increased risk of lung cancer. However, these studies had a number of methodological limitations. Thus, the objective of this study was to assess this association in a large population-based cohort of patients. METHODS: We used the United Kingdom Clinical Practice Research Datalink (CPRD) to identify a cohort of patients, at least 40 years of age, newly-diagnosed with heart failure, or supra-ventricular arrhythmia. A nested case-control analysis was conducted where each incident case of lung cancer identified during follow-up was randomly matched with up to 10 controls. Exposure to CGs was assessed in terms of ever use, cumulative duration of use and cumulative dose. Rate ratios (RRs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression after adjusting for potential confounders. RESULTS: A total of 129,002 patients were included, and followed for a mean (SD) of 4.7 (3.8) years. During follow-up, 1237 patients were newly-diagnosed with lung cancer. Overall, ever use of CGs was not associated with an increased risk of lung cancer when compared to never use (RR = 1.09, 95% CI: 0.94-1.26). In addition, no dose-response relationship was observed in terms of cumulative duration of use and cumulative dose with all RRs around the null value across quartile categories. CONCLUSION: The results of this large population-based study indicate that the use of CGs is not associated with an increased risk of lung cancer.
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Couraud et al. (2014) conducted a case-control in Heart failure, atrial fibrillation, atrial flutter, or supra-ventricular tachycardia (n=129,002). Cardiac glycosides vs. Never use of cardiac glycosides was evaluated on Incident lung cancer (RR 1.09, 95% CI 0.94-1.26). Ever use of cardiac glycosides was not associated with an increased risk of lung cancer compared to never use (RR 1.09).
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