β-Blocker use at lung cancer diagnosis compared with nonuse in relation to lung cancer–specific mortality by tumor stage in patients diagnosed with primary non–small cell lung cancer in Sweden between July 1, 2006 and December 31, 2014.
Early disease | Locoregionally advanced | Distant metastases | |||||
---|---|---|---|---|---|---|---|
(stages I–II) | (stage III) | (stage IV) | |||||
N = 4,162 | N = 4,067 | N = 9,042 | |||||
β-Blockersa | No. of events | HRb (95% CI) | No. of events | HRb (95% CI) | No. of events | HRb (95% CI) | |
Any β-blocker | 432 | 1.01 (0.89–1.16) | 866 | 0.96 (0.88–1.06) | 2,163 | 1.01 (0.95–1.07) | |
By adrenoreceptor selectivity | |||||||
β1-Receptor selectivec | 398 | 1.03 (0.90–1.18) | 788 | 0.94 (0.85–1.03) | 2,005 | 1.01 (0.95–1.07) | |
Nonselective (β1/β2-blocking)d | 26 | 0.90 (0.61–1.33) | 60 | 1.26 (0.97–1.63) | 133 | 0.99 (0.83–1.18) | |
α1- and β1/β2-blockinge | 10 | 1.06 (0.56–2.00) | 17 | 0.76 (0.47–1.24) | 39 | 0.88 (0.64–1.21) | |
By solubility | |||||||
Lipophilicf | 336 | 0.98 (0.85–1.13) | 668 | 1.00 (0.90–1.10) | 1,654 | 1.02 (0.96–1.09) | |
Hydrophilicg | 102 | 1.04 (0.84–1.29) | 214 | 0.90 (0.78–1.04) | 540 | 0.99 (0.90–1.09) |
Note: “No. of events” column shows number of outcome events among β-blocker users.
↵aExposed if β-blockers collected during 1 year before cancer diagnosis would last until cancer diagnosis date, unexposed otherwise.
↵bAdjusted for age, sex, stage, histology, year of diagnosis, region of residence, attained education, marital status, comorbidity score (number of distinct ATC classes prescribed during 1 year prior to diagnosis), comorbidity (coronary artery disease, heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, asthma, diabetes), other antihypertensive medications, nonsteroidal anti-inflammatory drugs, aspirin, statins.
↵cIncludes metoprolol, atenolol, bisoprolol.
↵dIncludes pindolol, propranolol, sotalol.
↵eIncludes labetalol, carvedilol.
↵fIncludes bisoprolol, carvedilol, labetalol, metoprolol, pindolol, propranolol, metoprolol + felodipine.
↵gIncludes sotalol, atenolol.