title: Cardiac glycosides use and the risk of lung cancer: a nested case-control study.
abstract: BACKGROUND
  Two 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  A 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.
  
  
  CONCLUSIONS
  The results of this large population-based study indicate that the use of CGs is not associated with an increased risk of lung cancer.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Couraud
authors.forename: Laurent
authors.initials: L
authors.lastname: Azoulay
authors.forename: Sophie
authors.initials: S
authors.lastname: Dell'Aniello
authors.affiliation: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal H3T 1E2, Quebec, Canada. samy.suissa@mcgill.ca.
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
mesh_terms: D000368:Aged; D002301:Cardiac Glycosides / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006331:Heart Diseases / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment
chemical_list: D002301:Cardiac Glycosides
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