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Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer
BACKGROUND: Venous thromboembolic events (VTE) are common in cancer patients and associated with higher mortality. In vivo thrombosis and anticoagulation might be involved in tumor growth and progression. We studied the association of warfarin and other anticoagulant use as antithrombotic medication...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575900/ https://www.ncbi.nlm.nih.gov/pubmed/28851310 http://dx.doi.org/10.1186/s12885-017-3579-8 |
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author | Kinnunen, Pete T. T. Murtola, Teemu J. Talala, Kirsi Taari, Kimmo Tammela, Teuvo L. J. Auvinen, Anssi |
author_facet | Kinnunen, Pete T. T. Murtola, Teemu J. Talala, Kirsi Taari, Kimmo Tammela, Teuvo L. J. Auvinen, Anssi |
author_sort | Kinnunen, Pete T. T. |
collection | PubMed |
description | BACKGROUND: Venous thromboembolic events (VTE) are common in cancer patients and associated with higher mortality. In vivo thrombosis and anticoagulation might be involved in tumor growth and progression. We studied the association of warfarin and other anticoagulant use as antithrombotic medication and prostate cancer (PCa) death in men with the disease. METHODS: The study included 6,537 men diagnosed with PCa during 1995-2009. Information on anticoagulant use was obtained from a national reimbursement registry. Cox regression with adjustment for age, PCa risk group, primary therapy and use of other medication was performed to compare risk of PCa death between warfarin users with 1) men using other types of anticoagulants and 2) non-users of anticoagulants. Medication use was analyzed as a time-dependent variable to minimize immortal time bias. RESULTS: In total, 728 men died from PCa during a median follow-up of 9 years. Compared to anticoagulant non-users, post-diagnostic use of warfarin was associated with an increased risk of PCa death (overall HR 1.47, 95% CI 1.13-1.93). However, this was limited to low-dose, low-intensity use. Otherwise, the risk was similar to anticoagulant non-users. Additionally, we found no risk difference between warfarin and other types of anticoagulants. Pre-diagnostic use of warfarin was not associated with the risk of PCa death. CONCLUSIONS: We found no reduction in risk of PCa death associated with warfarin use. Conversely, the risk was increased in short-term use, which is probably explained by a higher risk of thrombotic events prompting warfarin use in patients with terminal PCa. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-017-3579-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5575900 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55759002017-08-30 Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer Kinnunen, Pete T. T. Murtola, Teemu J. Talala, Kirsi Taari, Kimmo Tammela, Teuvo L. J. Auvinen, Anssi BMC Cancer Research Article BACKGROUND: Venous thromboembolic events (VTE) are common in cancer patients and associated with higher mortality. In vivo thrombosis and anticoagulation might be involved in tumor growth and progression. We studied the association of warfarin and other anticoagulant use as antithrombotic medication and prostate cancer (PCa) death in men with the disease. METHODS: The study included 6,537 men diagnosed with PCa during 1995-2009. Information on anticoagulant use was obtained from a national reimbursement registry. Cox regression with adjustment for age, PCa risk group, primary therapy and use of other medication was performed to compare risk of PCa death between warfarin users with 1) men using other types of anticoagulants and 2) non-users of anticoagulants. Medication use was analyzed as a time-dependent variable to minimize immortal time bias. RESULTS: In total, 728 men died from PCa during a median follow-up of 9 years. Compared to anticoagulant non-users, post-diagnostic use of warfarin was associated with an increased risk of PCa death (overall HR 1.47, 95% CI 1.13-1.93). However, this was limited to low-dose, low-intensity use. Otherwise, the risk was similar to anticoagulant non-users. Additionally, we found no risk difference between warfarin and other types of anticoagulants. Pre-diagnostic use of warfarin was not associated with the risk of PCa death. CONCLUSIONS: We found no reduction in risk of PCa death associated with warfarin use. Conversely, the risk was increased in short-term use, which is probably explained by a higher risk of thrombotic events prompting warfarin use in patients with terminal PCa. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-017-3579-8) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-29 /pmc/articles/PMC5575900/ /pubmed/28851310 http://dx.doi.org/10.1186/s12885-017-3579-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kinnunen, Pete T. T. Murtola, Teemu J. Talala, Kirsi Taari, Kimmo Tammela, Teuvo L. J. Auvinen, Anssi Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer |
title | Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer |
title_full | Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer |
title_fullStr | Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer |
title_full_unstemmed | Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer |
title_short | Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer |
title_sort | prostate cancer-specific survival among warfarin users in the finnish randomized study of screening for prostate cancer |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575900/ https://www.ncbi.nlm.nih.gov/pubmed/28851310 http://dx.doi.org/10.1186/s12885-017-3579-8 |
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