The aim of the present study was to clarify the influence of candesartan-based therapy
on subsequent carcinogenesis and cancer death in patients with coronary artery disease
with hypertension in a substudy of a multicenter, prospective, randomized, controlled
trial. That trial compared the effects of candesartan-based therapy with those of
non-angiotensin receptor blocker (ARB)-based standard therapy on major adverse cardiovascular
events. Hypertensive patients with coronary artery disease were randomly assigned
to receive either candesartan-based (n = 1,024) or non–ARB-based pharmacotherapy,
including angiotensin-converting enzyme inhibitors (n = 1,025). During a median follow-up
of 4.2 years, 1,606 adverse events (798 in the candesartan group and 808 in the non-ARB
standard group) were reported. Among them, new cancer occurred in 5.37% of subjects
in the candesartan group and 5.66% of subjects in the standard therapy group (hazard
ratio 0.95, 95% confidence interval 0.65 to 1.38). Cancer deaths occurred in 1.66%
in the candesartan group and 2.44% in the standard therapy group, respectively (hazard
ratio 0.74, 95% confidence interval 0.39 to 1.39). Kaplan-Meier estimates of survival
without new cancer and cancer deaths demonstrated that candesartan-based therapy does
not accelerate the occurrence of new cancer (log-rank, p = 0.84) or cancer death (p
= 0.39) compared to standard therapy. Advanced age and male gender were independently
and significantly correlated with the subsequent incidence of cancer. In conclusion,
the results of the present study suggest that candesartan-based therapy is not associated
with either carcinogenesis or cancer death compared to non-ARB standard therapy.
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Article Info
Publication History
Published online: November 18, 2011
Accepted:
September 29,
2011
Received in revised form:
September 29,
2011
Received:
August 9,
2011
Footnotes
This trial was funded by the Japan Research Promotion Society for Cardiovascular Diseases, Tokyo, Japan, which had no role in the study design, data collection, data analysis, data interpretation, or writing of this report.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
