Lowered Cancer Risk With <scp>ACE Inhibitor</scp>s/<scp>ARB</scp>s: A Population‐Based Cohort Study

Chiang, Yi-Ying; Chen, Kuen‐Bao; Tsai, Tung-Han; Tsai, Wen‐Chen

doi:10.1111/jch.12228

Cited by 40 publications

(22 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Indeed, a very large, cross-sectional cohort study, of nearly 300,000 individuals, identified a lower cancer risk in individuals on ACE inhibitors and ARBs as compared with those not on these medications. 35 Although these results should be cautiously interpreted and may be confounded, they do suggest a novel application of ACE inhibitors which should be explored in future studies.…”

Section: Discussionmentioning

confidence: 93%

Blood HER2 and Uromodulin as Causal Mediators of CKD

Sjaarda

Gerstein

Yusuf

et al. 2018

JASN

View full text Add to dashboard Cite

Many biomarkers have been epidemiologically linked with CKD; however, the possibility that such associations are due to reverse causation or confounding limits the utility of these biomarkers. To overcome this limitation, we used a Mendelian randomization (MR) approach to identify causal mediators of CKD. We performed MR by first identifying genetic determinants of 227 serum protein biomarkers assayed in 4147 participants of the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial who had early or prediabetes, and assessing the effects of these biomarkers on CKD in the CKD genetics consortium (=117,165; 12,385 cases) using the inverse-variance weighted (fixed-effects) method. We then estimated the relationship between the serum concentration of each biomarker identified and incident CKD in ORIGIN participants. MR identified uromodulin (UMOD) and human EGF receptor 2 (HER2) as novel, causal mediators of CKD (UMOD: odds ratio [OR], 1.30 per SD; 95% confidence interval [95% CI], 1.25 to 1.35; <5×10; HER2: OR, 1.30 per SD; 95% CI, 1.14 to 1.48; =8.0×10). Consistent with these findings, blood HER2 concentration associated with CKD events in ORIGIN participants (OR, 1.07 per SD; 95% CI, 1.01 to 1.13; =0.01). Additional exploratory MR analyses identified angiotensin-converting enzyme (ACE) as a regulator of HER2 levels (=0.13 per SD; 95% CI, 0.08 to 0.16; =2.5×10). This finding was corroborated by an inverse relationship between ACE inhibitor use and HER2 levels. Thus, UMOD and HER2 are independent causal mediators of CKD in humans, and serum HER2 levels are regulated in part by ACE. These biomarkers are potential therapeutic targets for CKD prevention.

show abstract

Section: Discussionmentioning

confidence: 93%

Blood HER2 and Uromodulin as Causal Mediators of CKD

Sjaarda

Gerstein

Yusuf

et al. 2018

JASN

View full text Add to dashboard Cite

show abstract

“…For example, ACE inhibitor or angiotensin receptor blockers have shown a protective effect against pancreatic cancer, according to one study 17. Khurana et al 18 demonstrated a similar outcome in patients at Veteran Affairs, after controlling for common variables.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous presentation of pancreatic cancer in a genetically unrelated couple

Yellu

Olowokure

2015

BMJ Case Reports

View full text Add to dashboard Cite

Patients with pancreatic cancer tend to have a poor prognosis despite aggressive treatment, and their 5-year overall survival rate remains dismal. Several risk factors could potentially trigger the development of pancreatic cancer but many of them identified so far have been only weakly linked. Occurrence of pancreatic cancer in a husband and wife around the same time in the same household even when exposed to similar environmental factors is rare. Although familial pancreatic cancer is a known entity, pancreatic cancer in genetically unrelated married couples has not been studied. Here we present such a scenario involving one couple. In this case report, we discuss the chronological events leading to pancreatic cancer in a genetically unrelated married couple and the risk factors that may have led to cancer, in addition to exploring the possible links.

show abstract

“…Two large population-based studies, from Denmark (10) and a recent study from 2017 in the UK (11), found no such association. Conversely, two large epidemiological studies published in 2014, conducted in the UK (12) and in Taiwan (13), demonstrated an association between ACEI/ARB use and a reduced risk of developing cancer. In a large population-based cohort of 17,897 patients from Denmark, treatment with ACEI was not associated with a reduced risk of developing cancer (10).…”

Section: Clinical Observationsmentioning

confidence: 98%

Renin–Angiotensin Inhibition in Combating Malignancy: A Review

Rosenthal

Gavras

2019

Anticancer Res

View full text Add to dashboard Cite

Our previous review of the literature assessed the existing knowledge (until 2000) about the possible link between angiotensin-converting enzyme inhibitors (ACEIs) and factors influencing the development of malignancies. We reviewed the literature for reports of statistical associations (or lack thereof) between ACEi treatment and incidence of specific cancers (e.g. breast, gastrointestinal, and skin). We concluded then that results from the epidemiological studies are conflicting, even taking the different methodology and endpoints into consideration, and thus inconclusive. Further investigation is needed beyond the observation period of most of these studies, and additional experimental studies are needed also to study the mechanisms by which agents blocking the renin-angiotensin system may obtain their inhibitory effect on tumor growth and metastasis. The present review elaborates further with more recent evidence from numerous human clinical studies from the past two decades (including large epidemiological studies, and long-term prospective and retrospective studies) on a protective association between ACEi treatment and the prognosis of patients with specific cancer types, malignancy characteristics or stage. Moreover, treatment with ACEI/angiotensin receptor blockers represents an adjuvant therapy with synergistic effects to chemotherapy and may improve patient outcomes (i.e. progression-free survival, and prolonged overall survival) in different types of cancers.

show abstract

Lowered Cancer Risk With ACE Inhibitors/ARBs: A Population‐Based Cohort Study

Cited by 40 publications

References 38 publications

Blood HER2 and Uromodulin as Causal Mediators of CKD

Blood HER2 and Uromodulin as Causal Mediators of CKD

Simultaneous presentation of pancreatic cancer in a genetically unrelated couple

Renin–Angiotensin Inhibition in Combating Malignancy: A Review

Contact Info

Product

Resources

About