Key result
ACEI/ARB use after cancer diagnosis was associated with a significantly lower risk of cancer-specific mortality in patients with gastric cancer (HR 0.87), but not in those with esophageal cancer.
Why the study?
The effect of ACEIs and ARBs on survival in patients with esophageal and gastric cancer was unclear.
Does the use of ACEIs or ARBs reduce cancer-specific mortality in patients with esophageal or gastric cancer and hypertension?
Cohort (n=4,577)
Does the use of ACEIs or ARBs reduce cancer-specific mortality in patients with esophageal or gastric cancer and hypertension?
Hazard Ratio: 0.87 (95% CI 0.78–0.97)
p-value: p=0.016
The use of ACEIs or ARBs after cancer diagnosis is associated with a reduced risk of cancer-specific mortality in patients with gastric cancer and hypertension.
Post-diagnosis ACEI/ARB use was associated with lower mortality; leaves open confounding versus effect in esophageal and gastric cancer.
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are used in treating cardiovascular diseases. Previous studies indicated that ACEIs/ARBs may benefit cancer patients by inhibiting tumor angiogenesis and proliferation. The effect of ACEIs/ARBs on cancer survival in esophageal and gastric cancer is still unclear. This study is to investigate the association between ACEIs/ARBs usage and esophageal and gastric cancer prognosis. METHODS: This retrospective cohort study identified esophageal and gastric cancer patients during 2008-2016 from the Taiwan Cancer Registry, and obtained medication usage and follow-up information from the National Health Insurance Research Database and Death Registry. Analysis groups were defined as ACEIs/ARBs user or non-user based on the usage of ACEIs/ARBs within the 6 months after cancer diagnosis. The stabilized inverse probability of treatment weighting using propensity scores was applied to balance covariates between study groups. We also used Kaplan-Meier estimates and Cox regression to compare survival outcome and estimate hazard ratios (HRs). RESULTS: We identified 14,463 and 21,483 newly-diagnosed esophageal and gastric cancer patients during 2008-2016. ACEIs/ARBs users were associated with lower risk of cancer-specific mortality, although only significantly in gastric cancer (gastric: adjusted HR = 0.87, 95% CI = 0.78-0.97; esophageal: adjusted HR =0.88, 95% CI = 0.76-1.02). A better survival outcome was observed among patients who received higher cumulative defined daily dose of ACEIs/ARBs. CONCLUSIONS: We found that using ACEIs/ARBs after cancer diagnosis were associated with lower risk of mortality. Our results add to the knowledge of the benefit of ACEIs/ARBs against mortality in individuals with esophageal/gastric cancer patients with hypertension.
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Li et al. (2022) conducted a cohort in Esophageal or gastric cancer with hypertension (n=4,577). Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) vs. ACEIs/ARBs non-users was evaluated on Cancer-specific mortality (gastric cancer) (HR 0.87, 95% CI 0.78-0.97, p=0.016). ACEI/ARB use after cancer diagnosis was associated with a significantly lower risk of cancer-specific mortality in patients with gastric cancer (HR 0.87), but not in those with esophageal cancer.
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