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Survival Benefit of Renin-Angiotensin System Blockers in Critically Ill Cancer Patients: A Retrospective Study.
- Source :
-
Cancers . Jun2023, Vol. 15 Issue 12, p3183. 11p. - Publication Year :
- 2023
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Abstract
- Simple Summary: The involvement of the renin-angiotensin pathway in both the regulation of the cardiovascular system and in tumorigenesis raises the question of the prognostic impact of renin-angiotensin system blockers (RABs) in cancer patients experiencing life-threatening complications. The aim of our retrospective study was to assess this impact in solid tumor patients requiring unplanned ICU admission over a 14-year period. Among 1845 patients mainly diagnosed with gastrointestinal and lung cancers, 414 (22.4%) were treated with RABs: 220 (53.1%) with angiotensin-receptor blockers (ARBs) and 194 (46.9%) with angiotensin-converting enzyme inhibitors (ACEis). ARBs use and ACEis use were both associated with improved in-ICU survival, whereas only ARBs use was associated with improved one-year survival. Increasing evidence argues for the promotion of tumorigenesis through activation of the renin-angiotensin system pathway. Accordingly, a benefit of renin-angiotensin system blockers (RABs) treatments has been suggested in patients with solid cancers in terms of survival. We aimed to evaluate in-ICU survival and one-year survival in cancer patients admitted to the ICU with respect to the use of RABs. We conducted a retrospective observational single-center study in a 24-bed medical ICU. We included all solid cancer patients (age ≥ 18 years) requiring unplanned ICU admission. From 2007 to 2020, 1845 patients with solid malignancies were admitted (median age 67 years (59–75), males 61.7%). The most frequent primary tumor sites were the gastrointestinal tract (26.8%), the lung (24.7%), the urological tract (20.1%), and gynecologic and breast cancers (13.9%). RABs were used in 414 patients, distributed into 220 (53.1%) with angiotensin-receptor blockers (ARBs) and 194 (46.9%) with angiotensin-converting enzyme inhibitors (ACEis). After multivariate adjustment, ARBs use (OR = 0.62, 95%CI (0.40–0.92), p = 0.03) and ACEis use (OR = 0.52, 95%CI (0.32–0.82), p = 0.006) were both associated with improved in-ICU survival. Treatment with ARBs was independently associated with decreased one-year mortality (OR = 0.6, 95%CI (0.4–0.9), p = 0.02), whereas treatment with ACEis was not. In conclusion, this study argues for a beneficial impact of RABs use on the prognosis of critically ill cancer patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INTENSIVE care units
*SCIENTIFIC observation
*CONFIDENCE intervals
*CRITICALLY ill
*RENIN-angiotensin system
*PATIENTS
*ACE inhibitors
*RETROSPECTIVE studies
*ACQUISITION of data
*LUNG tumors
*CANCER patients
*CELLULAR signal transduction
*GASTROINTESTINAL tumors
*CANCER
*URINARY organs
*MEDICAL records
*SURVIVAL analysis (Biometry)
*DESCRIPTIVE statistics
*TUMORS
*ANGIOTENSIN receptors
*ODDS ratio
*BREAST tumors
Subjects
Details
- Language :
- English
- ISSN :
- 20726694
- Volume :
- 15
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Cancers
- Publication Type :
- Academic Journal
- Accession number :
- 164614961
- Full Text :
- https://doi.org/10.3390/cancers15123183