Table 5.

Selected β-blocker use compared with nonuse in relation to lung cancer–specific mortality overall and by stage among patients diagnosed with NSCLC in Sweden between July 1, 2006 and December 31, 2014.

Early diseaseLocoregionally advancedDistant metastases
All patients(stages I–II)(stage III)(stage IV)
N = 18,429N = 4,162N = 4,067N = 9,042
β-BlockersaSelectivity ratioSolubilityNo. of eventsHRb (95% CI)No. of eventsHRb (95% CI)No. of eventsHRb (95% CI)No. of eventsHRb (95% CI)
Nonselectivecβ2 vs. β1
 Propranolol8.3HL1401.22 (1.03–1.45)181.01 (0.63–1.61)321.25 (0.88–1.78)771.14 (0.91–1.43)
 Sotalol12.0HD781.00 (0.80–1.25)60.70 (0.31–1.56)231.17 (0.77–1.77)440.95 (0.71–1.28)
 Carvedilold4.5ML670.86 (0.67–1.10)80.91 (0.45–1.86)170.77 (0.47–1.24)380.87 (0.63–1.20)
β1-Receptor selectiveβ1 vs. β2
 Metoprolol2.3HL2,0641.00 (0.95–1.06)2330.92 (0.79–1.08)4730.94 (0.84–1.05)1,2251.03 (0.97–1.11)
 Atenolol4.7HD8360.99 (0.92–1.07)961.06 (0.86–1.32)1910.87 (0.75–1.02)4960.99 (0.90–1.09)
 Bisoprolol13.5ML5821.05 (0.96–1.14)781.21 (0.94–1.55)1431.04 (0.87–1.24)3250.98 (0.87–1.10)
  • Note: “No. of events” column shows number of outcome events among β-blocker users.

  • Abbreviations: HD, hydrophilic; HL, highly lipophilic; ML, moderately lipophilic.

  • aExposed if β-blockers collected during 1 year before 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.

  • cBlock β1 and β2 adrenergic receptors.

  • dCarvedilol is a nonselective β-blocker that blocks β1 and β2 adrenergic receptors as well as the α1 adrenergic receptors.