The potential impact of renin-angiotensin system inhibitors on cancer survival and recurrence: A systemic review and meta-analysis.

Autor:	Fatima K; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Ellahi A; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Adil M; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Kashif H; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Uzair M; Medical College, The Aga Khan University, Karachi, Pakistan., Ashraf N; Department of Medicine, The Aga Khan University, Karachi, Pakistan., Barolia M; Medical College, The Aga Khan University, Karachi, Pakistan., Hyder M; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Nakhuda A; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Ayub M; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Butt SJ; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Rashid AM; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	Journal of cardiovascular pharmacology [J Cardiovasc Pharmacol] 2024 Jun 25. Date of Electronic Publication: 2024 Jun 25.
DOI:	10.1097/FJC.0000000000001600
Abstrakt:	Renin-angiotensin-system inhibitors (RASi), specifically angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs), are widely used anti-hypertensives. Their impact on the prognostic outcomes among cancer patients has been subject to scrutiny and debate. The aim of this study is to evaluate the effect of RASi on survival in cancer patients. We systematically searched PubMed, Web of Science, Embase and Cochrane Library for relevant studies published until April 1st, 2022. All the studies, interventional or observational, which examined effects of ARBs and ACEi on cancer prognosis compared to a control group and reported the survival outcomes and Hazards Ratios were included in the analysis. From each study, pooled hazard ratios (HR) with corresponding 95% confidence intervals (95% CI) were identified and collected. Subgroup analysis was conducted to investigate heterogeneity. Sixty-one studies were included in this meta-analysis. Data of 343,283 participants were used in the study. It was found that RASi improved overall survival (OS) (HR=0.88; 95% CI: 0.82-0.93; P<0.0001), progression free survival (PFS) (HR=0.72; 95% CI: 0.65-0.79; P<0.00001), disease specific survival (DSS) (HR=0.86; 95% CI: 0.71-1.04; P=0.03), and recurrence free survival (RFS) (HR=0.74; 95% CI: 0.58-0.93; P=0.01) in cancer patients. The effect of RASi on OS varied depending on the type of cancer or type of RASi (ACEi or ARBs), according to subgroup analysis. The usage of RAS inhibitors has a positive impact on survival outcomes and recurrence among cancer patients. Competing Interests: Conflict of Interest Disclosure: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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