Abstract

BackgroundTwo 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.MethodsWe 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.ResultsA 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.ConclusionThe results of this large population-based study indicate that the use of CGs is not associated with an increased risk of lung cancer.

Highlights

  • Two studies have reported statistically significant associations between the use of cardiac glycosides (CGs) and an increased risk of lung cancer

  • Given the limited data assessing the association between the use of CGs and the risk of lung cancer, we conducted a large population-based study to investigate whether the use of these drugs are associated with an increased risk of lung cancer in patients newly-diagnosed with heart failure (HF), atrial fibrillation (AF), atrial flutter (AFl) and/or supra-ventricular tachycardia (SVT)

  • Study population Within the Clinical Practice Research Datalink (CPRD) population, we identified all patients diagnosed for the first time with HF, AF, AFl and/or SVT, between January 1, 1988 and December 31, 2010, and followed until December 31, 2012

Read more

Summary

Introduction

Two studies have reported statistically significant associations between the use of cardiac glycosides (CGs) and an increased risk of lung cancer. The CG family includes digoxin, digitoxin and lanatoside C which remain important drugs in the treatment of atrial fibrillation (AF), some types of heart failure (HF), atrial flutter (AFl) and other supra-ventricular tachycardia (SVT) [1,2]. Due to their ability to bind to estrogen receptors, [3] there has been interest in assessing whether the use of CGs is associated with the incidence of breast cancer. Only two only observational studies have investigated the link between the use of CGs and lung cancer incidence. [11,12] In one study, the use of digitalis-related compounds was associated with a 65% increased risk of death from lung cancer. [11] In the other study, digitoxin users were found to have a significantly higher incidence of lung cancer compared to a matched control population (standardized incidence ratio: 1.35, 95% confidence interval [CI]: 1.04-1.74). [12] lung cancer was a secondary outcome in these studies, and the models were not adjusted for important potential confounders, such as smoking.

Objectives
Methods
Results
Discussion
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.