Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

Cardwell, Chris R.; Pottegård, Anton; Vaes, Evelien; Garmo, Hans; Murray, Liam J.; Brown, Chris; Vissers, Pauline A. J.; O’Rorke, Michael; Visvanathan, Kala; Cronin-Fenton, Deirdre; De Schutter, Harlinde; Lambe, Mats; Powe, Des G.; van Herk-Sukel, Myrthe P. P.; Gavin, Anna; Friis, Søren; Sharp, Linda; Bennett, Kathleen

doi:10.1186/s13058-016-0782-5

Breast Cancer Research

Table 4 Secondary and sensitivity analyses for pooled analysis of the association between propranolol and non-selective beta-blocker use and breast cancer-specific and all-cause mortality

From: Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

Medication usage	Deaths	Patients	Person-years	Unadjusted			Fully adjusted
Medication usage	Deaths	Patients	Person-years	HR (95% CI)	P	Hetero I ² (P)	Adjusted HR (95% CI)	P	Hetero I ² (P)
Breast cancer-specific mortality
Medication use after diagnosis
Main time-varying covariate analysis in stage 1–3 breast cancer patients
Propranolol in stages 1–3	3389	44,376	112,450	1.02 (0.82, 1.26)	0.88	0% (0.84)	1.06 (0.85, 1.33)	0.62	0% (0.60)
Main time-varying covariate analysis in all breast cancer patients
Any beta-blocker	5419	55,252	181,714	1.25 (1.11, 1.40)	<0.001	63% (0.03)	1.07 (0.99, 1.16)	0.10	0% (0.82)
Analysis based upon use in year after diagnosis^a
Propranolol	5426	55,252	181,959	0.94 (0.72, 1.21)	0.61	35% (0.19)	1.07 (0.72, 1.60)	0.72	65% (0.02)
Non-selective beta-blocker	5426	55,252	181,959	1.10 (0.87, 1.39)	0.43	51% (0.09)	1.15 (0.85, 1.56)	0.35	60% (0.04)
Medication use before diagnosis^b
Propranolol	6883	53,870	215,978	0.97 (0.82, 1.15)	0.73	0% (0.51)	1.03 (0.86, 1.22)	0.78	3% (0.39)
Non-selective beta-blocker	6883	53,870	215,978	1.09 (0.95, 1.25)	0.22	0% (0.47)	1.05 (0.92, 1.21)	0.45	0% (0.68)
All-cause mortality
Medication use after diagnosis
Main time-varying covariate analysis in stage 1–3 breast cancer patients
Propranolol in stages 1–3^c	17,219	96,097	382,1512	1.07 (0.93, 1.24)	0.32	29% (0.21)	1.13 (1.02, 1.24)	0.02	0% (0.46)
Main time-varying covariate analysis in all breast cancer patients
Any beta-blocker	25,472	133,251	570,968	1.57 (1.41, 1.75)	<0.001	92% (<0.001)	1.12 (1.05, 1.20)	<0.001	65% (0.006)
Analysis based upon use in year after diagnosis^a
Propranolol	25,487	133,251	571,213	1.02 (0.89, 1.16)	0.82	48% (0.06)	1.04 (0.89, 1.21)	0.62	48% (0.06)
Non-selective beta-blocker	25,487	133,251	571,213	1.35 (1.17, 1.55)	<0.001	78% (<0.001)	1.14 (0.99, 1.30)	0.06	68% (0.003)
Medication use before diagnosis^b
Propranolol	31,556	139,760	664,448	0.97 (0.86, 1.09)	0.60	44% (0.09)	1.02 (0.94, 1.10)	0.68	0% (0.54)
Non-selective beta-blocker	31,556	139,760	664,448	1.30 (1.14, 1.49)	<0.001	80% (<0.001)	1.13 (1.06, 1.21)	<0.001	27% (0.21)

^aSimplified analysis, not requiring time-varying covariate use, comparing medication users with non-users in the first year after diagnosis in individuals living more than 1 year after cancer diagnosis; fully adjusted column adjusted for age, year, stage and all confounders presented in Table 1
^bBased on use in the year prior to diagnosis, restricted to individuals with 1 year of records prior to diagnosis; fully adjusted column only adjusted for age at diagnosis and year of diagnosis
^cExcludes the Belgian cohort
CI confidence interval, HR hazard ratio

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ISSN: 1465-542X

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