title: Effect of statins and anticoagulants on prostate cancer aggressiveness.
abstract: OBJECTIVE
  Statins and anticoagulants (ACs) have both been associated with a less-aggressive prostate cancer (PCa) and a better outcome after treatment of localized PCa. The results of these studies might have been confounded because patients might often take both medications. We examined their respective influence on PCa aggressiveness at initial diagnosis.
  
  
  METHODS
  We analyzed 381 patients treated with either external beam radiotherapy or brachytherapy for low-risk (n = 152), intermediate-risk (n = 142), or high-risk (n = 87) localized PCa. Univariate and multivariate logistic regression analyses were used to investigate an association between these drug classes and prostate cancer aggressiveness. We tested whether the concomitant use of statins and ACs had a different effect than that of either AC or statin use alone.
  
  
  RESULTS
  Of the 381 patients, 172 (45.1%) were taking statins and 141 (37.0%) ACs; 105 patients (27.6%) used both. On univariate analysis, the statin and AC users were associated with the prostate-specific antigen (PSA) level (p = .017) and National Comprehensive Cancer Network risk group (p = .0022). On multivariate analysis, statin use was associated with a PSA level <10 ng/mL (odds ratio, 2.9; 95% confidence interval, 1.3-6.8; p = .012) and a PSA level >20 ng/mL (odds ratio, 0.29; 95% confidence interval, 0.08-0.83; p = .03). The use of ACs was associated with a PSA level >20 ng/mL (odds ratio, 0.13; 95% confidence interval, 0.02-0.59, p = .02).
  
  
  CONCLUSIONS
  Both AC and statins have an effect on PCa aggressiveness, with statins having a more stringent relationship with the PSA level, highlighting the importance of considering statin use in studies of PCa aggressiveness.
authors.affiliation: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Moein
authors.initials: M
authors.lastname: Alizadeh
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Sylvestre
authors.forename: Thomas
authors.initials: T
authors.lastname: Zilli
authors.forename: Thu
authors.initials: T
authors.lastname: Van Nguyen
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Guay
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bahary
authors.forename: Daniel
authors.initials: D
authors.lastname: Taussky
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology*; D001918:Brachytherapy; D016001:Confidence Intervals; D004359:Drug Therapy, Combination; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D016017:Odds Ratio; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000532:radiotherapy*; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk
chemical_list: D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017430:Prostate-Specific Antigen