β-Blocker use and mortality in cancer patients: systematic review and meta-analysis of observational studies.
A number of epidemiologic studies have attempted to link the use of β blockers to mortality in cancer patients, but their findings have been inconclusive. A meta-analysis was carried out to derive a more precise estimation. Relevant studies were identified by searching PubMed and EMBASE to May 2015. We calculated the summary hazard ratios (HRs) and 95% confidence intervals (CIs) using random-effects models. Twenty cohort studies and four case-control studies involving 76 538 participants were included. The overall results showed that patients who used β blockers after diagnosis had an HR of 0.89 (95% CI 0.81-0.98) for all-cause mortality compared with nonusers. Those who used β blockers after diagnosis (vs. nonusers) had an HR of 0.89 (95% CI 0.79-0.99) for cancer-specific mortality. Prediagnostic use of β blockers showed no beneficial effect on all-cause mortality or cancer-specific mortality. Stratifying by cancer type, only breast cancer patients who used β blockers after diagnosis had a prolonged overall survival. A linear but nonsignificant trend was found between postdiagnostic β-blocker use and mortality of cancer patients. In conclusion, the average effect of β-blocker use after diagnosis but not before diagnosis is beneficial for the survival of cancer patients.
aCenter of Clinical Laboratory Science bDepartment of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University cCentral Laboratory, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, China.
Shanliang
S
Zhong
Dandan
D
Yu
Xiaohui
X
Zhang
Xiu
X
Chen
Sujin
S
Yang
Jinhai
J
Tang
Jianhua
J
Zhao
Shukui
S
Wang
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D016022:Case-Control Studies; D006801:Humans; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality*; D064887:Observational Studies as Topic; D011379:Prognosis; D015996:Survival Rate
D000319:Adrenergic beta-Antagonists