Daily Aspirin Reduced the Incidence of Hepatocellular Carcinoma and Overall Mortality in Patients with Cirrhosis
Cirrhosis is the primary risk factor for hepatocellular carcinoma (HCC) and gastrointestinal bleeding (GI). We aimed to assess the efficacy and safety of daily aspirin on HCC occurrence, overall survival, and GI bleeding in cirrhotic patients. A total of 35,898 eligible cases were enrolled for analy...
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| Veröffentlicht in: | Cancers 2023-05, Vol.15 (11), p.2946 |
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| creator | Lee, Chern-Horng Hsu, Chiu-Yi Yen, Tzung-Hai Wu, Tsung-Han Yu, Ming-Chin Hsieh, Sen-Yung |
| description | Cirrhosis is the primary risk factor for hepatocellular carcinoma (HCC) and gastrointestinal bleeding (GI). We aimed to assess the efficacy and safety of daily aspirin on HCC occurrence, overall survival, and GI bleeding in cirrhotic patients.
A total of 35,898 eligible cases were enrolled for analyses from an initial 40,603 cirrhotic patients without tumor history. Patients continuously treated with aspirin for at least 84 days were in the therapy group, whereas those without treatment were controls. A 1:2 propensity score matching by age, sex, comorbidities, drugs, and significant clinical laboratory tests with covariate assessment was used.
Multivariable regression analyses revealed that daily aspirin use was independently associated with a reduced risk of HCC (three-year HR 0.57; 95% CI 0.37-0.87;
= 0.0091; five-year HR 0.63, 95% CI 0.45-0.88;
= 0.0072) inversely correlated with the treatment duration [3-12 months: HR 0.88 (95% CI 0.58-1.34); 12-36 months: HR 0.56 (0.31-0.99); and ≥ 36 months: HR 0.37 (0.18-0.76)]. Overall mortality rates were significantly lower among aspirin users compared with untreated controls [three-year HR 0.43 (0.33-0.57); five-year HR 0.51 (0.42-0.63)]. Consistent results were obtained when the laboratory data were included in the propensity score for matching.
Long-term aspirin use significantly reduced the incidence of HCC and overall mortality without increasing gastrointestinal bleeding in cirrhotic patients. |
| doi_str_mv | 10.3390/cancers15112946 |
| format | Article |
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A total of 35,898 eligible cases were enrolled for analyses from an initial 40,603 cirrhotic patients without tumor history. Patients continuously treated with aspirin for at least 84 days were in the therapy group, whereas those without treatment were controls. A 1:2 propensity score matching by age, sex, comorbidities, drugs, and significant clinical laboratory tests with covariate assessment was used.
Multivariable regression analyses revealed that daily aspirin use was independently associated with a reduced risk of HCC (three-year HR 0.57; 95% CI 0.37-0.87;
= 0.0091; five-year HR 0.63, 95% CI 0.45-0.88;
= 0.0072) inversely correlated with the treatment duration [3-12 months: HR 0.88 (95% CI 0.58-1.34); 12-36 months: HR 0.56 (0.31-0.99); and ≥ 36 months: HR 0.37 (0.18-0.76)]. Overall mortality rates were significantly lower among aspirin users compared with untreated controls [three-year HR 0.43 (0.33-0.57); five-year HR 0.51 (0.42-0.63)]. Consistent results were obtained when the laboratory data were included in the propensity score for matching.
Long-term aspirin use significantly reduced the incidence of HCC and overall mortality without increasing gastrointestinal bleeding in cirrhotic patients.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15112946</identifier><identifier>PMID: 37296908</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antiplatelet therapy ; Aspirin ; Bleeding ; Cancer therapies ; Cirrhosis ; Comorbidity ; Diabetes ; Hepatitis B ; Hepatitis C ; Hepatocellular carcinoma ; Hepatoma ; Hospitalization ; Hypertension ; Laboratories ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Medical research ; Medicine, Experimental ; Metastasis ; Mortality ; Patient outcomes ; Patients ; Risk factors ; Tumors</subject><ispartof>Cancers, 2023-05, Vol.15 (11), p.2946</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-cdb63060a504d8e3ca20557a358a8a7a6a37237511083131a4ddf13f473949a33</citedby><cites>FETCH-LOGICAL-c489t-cdb63060a504d8e3ca20557a358a8a7a6a37237511083131a4ddf13f473949a33</cites><orcidid>0000-0002-2756-678X ; 0000-0002-0907-1505 ; 0000-0002-5083-8851 ; 0000-0001-7171-3532</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251874/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251874/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37296908$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Chern-Horng</creatorcontrib><creatorcontrib>Hsu, Chiu-Yi</creatorcontrib><creatorcontrib>Yen, Tzung-Hai</creatorcontrib><creatorcontrib>Wu, Tsung-Han</creatorcontrib><creatorcontrib>Yu, Ming-Chin</creatorcontrib><creatorcontrib>Hsieh, Sen-Yung</creatorcontrib><title>Daily Aspirin Reduced the Incidence of Hepatocellular Carcinoma and Overall Mortality in Patients with Cirrhosis</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>Cirrhosis is the primary risk factor for hepatocellular carcinoma (HCC) and gastrointestinal bleeding (GI). We aimed to assess the efficacy and safety of daily aspirin on HCC occurrence, overall survival, and GI bleeding in cirrhotic patients.
A total of 35,898 eligible cases were enrolled for analyses from an initial 40,603 cirrhotic patients without tumor history. Patients continuously treated with aspirin for at least 84 days were in the therapy group, whereas those without treatment were controls. A 1:2 propensity score matching by age, sex, comorbidities, drugs, and significant clinical laboratory tests with covariate assessment was used.
Multivariable regression analyses revealed that daily aspirin use was independently associated with a reduced risk of HCC (three-year HR 0.57; 95% CI 0.37-0.87;
= 0.0091; five-year HR 0.63, 95% CI 0.45-0.88;
= 0.0072) inversely correlated with the treatment duration [3-12 months: HR 0.88 (95% CI 0.58-1.34); 12-36 months: HR 0.56 (0.31-0.99); and ≥ 36 months: HR 0.37 (0.18-0.76)]. Overall mortality rates were significantly lower among aspirin users compared with untreated controls [three-year HR 0.43 (0.33-0.57); five-year HR 0.51 (0.42-0.63)]. Consistent results were obtained when the laboratory data were included in the propensity score for matching.
Long-term aspirin use significantly reduced the incidence of HCC and overall mortality without increasing gastrointestinal bleeding in cirrhotic patients.</description><subject>Antiplatelet therapy</subject><subject>Aspirin</subject><subject>Bleeding</subject><subject>Cancer therapies</subject><subject>Cirrhosis</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Hepatitis B</subject><subject>Hepatitis C</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatoma</subject><subject>Hospitalization</subject><subject>Hypertension</subject><subject>Laboratories</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Metastasis</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Tumors</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptUs1vFCEUJ0Zjm9qzN0Pixcu2fA0MJ7PZqm1SU2P0TF6B6dLMwAgzNfvfy9jabBvhAIHfx_u9PITeUnLCuSanFqL1udCGUqaFfIEOGVFsJaUWL_fuB-i4lFtSF-dUSfUaHXDFtNSkPUTjGYR-h9dlDDlE_N272XqHp63HF9EG56sFTh0-9yNMyfq-n3vIeAPZhpgGwBAdvrrzGfoef015gj5MO1ylvsEUfJwK_h2mLd6EnLephPIGveqgL_744TxCPz9_-rE5X11efbnYrC9XVrR6Wll3LTmRBBoiXOu5BUaaRgFvWmhBgYSagasanbSccgrCuY7yTiiuhQbOj9DHe91xvh68s7WUWqMZcxgg70yCYJ7-xLA1N-nOUMIa2ipRFT48KOT0a_ZlMkMoSwcg-jQXw1omZCuVWKDvn0Fv05xjzbeguFZS0z3UDfTehNilamwXUbNWDRNK0L-2J_9B1e38EGyKvgv1_Qnh9J5gcyol--4xJCVmGRTzbFAq491-bx7x_8aC_wFb4LlJ</recordid><startdate>20230527</startdate><enddate>20230527</enddate><creator>Lee, Chern-Horng</creator><creator>Hsu, Chiu-Yi</creator><creator>Yen, Tzung-Hai</creator><creator>Wu, Tsung-Han</creator><creator>Yu, Ming-Chin</creator><creator>Hsieh, Sen-Yung</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2756-678X</orcidid><orcidid>https://orcid.org/0000-0002-0907-1505</orcidid><orcidid>https://orcid.org/0000-0002-5083-8851</orcidid><orcidid>https://orcid.org/0000-0001-7171-3532</orcidid></search><sort><creationdate>20230527</creationdate><title>Daily Aspirin Reduced the Incidence of Hepatocellular Carcinoma and Overall Mortality in Patients with Cirrhosis</title><author>Lee, Chern-Horng ; Hsu, Chiu-Yi ; Yen, Tzung-Hai ; Wu, Tsung-Han ; Yu, Ming-Chin ; Hsieh, Sen-Yung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-cdb63060a504d8e3ca20557a358a8a7a6a37237511083131a4ddf13f473949a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antiplatelet therapy</topic><topic>Aspirin</topic><topic>Bleeding</topic><topic>Cancer therapies</topic><topic>Cirrhosis</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Hepatitis B</topic><topic>Hepatitis C</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatoma</topic><topic>Hospitalization</topic><topic>Hypertension</topic><topic>Laboratories</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Metastasis</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Chern-Horng</creatorcontrib><creatorcontrib>Hsu, Chiu-Yi</creatorcontrib><creatorcontrib>Yen, Tzung-Hai</creatorcontrib><creatorcontrib>Wu, Tsung-Han</creatorcontrib><creatorcontrib>Yu, Ming-Chin</creatorcontrib><creatorcontrib>Hsieh, Sen-Yung</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Chern-Horng</au><au>Hsu, Chiu-Yi</au><au>Yen, Tzung-Hai</au><au>Wu, Tsung-Han</au><au>Yu, Ming-Chin</au><au>Hsieh, Sen-Yung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Daily Aspirin Reduced the Incidence of Hepatocellular Carcinoma and Overall Mortality in Patients with Cirrhosis</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2023-05-27</date><risdate>2023</risdate><volume>15</volume><issue>11</issue><spage>2946</spage><pages>2946-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Cirrhosis is the primary risk factor for hepatocellular carcinoma (HCC) and gastrointestinal bleeding (GI). We aimed to assess the efficacy and safety of daily aspirin on HCC occurrence, overall survival, and GI bleeding in cirrhotic patients.
A total of 35,898 eligible cases were enrolled for analyses from an initial 40,603 cirrhotic patients without tumor history. Patients continuously treated with aspirin for at least 84 days were in the therapy group, whereas those without treatment were controls. A 1:2 propensity score matching by age, sex, comorbidities, drugs, and significant clinical laboratory tests with covariate assessment was used.
Multivariable regression analyses revealed that daily aspirin use was independently associated with a reduced risk of HCC (three-year HR 0.57; 95% CI 0.37-0.87;
= 0.0091; five-year HR 0.63, 95% CI 0.45-0.88;
= 0.0072) inversely correlated with the treatment duration [3-12 months: HR 0.88 (95% CI 0.58-1.34); 12-36 months: HR 0.56 (0.31-0.99); and ≥ 36 months: HR 0.37 (0.18-0.76)]. Overall mortality rates were significantly lower among aspirin users compared with untreated controls [three-year HR 0.43 (0.33-0.57); five-year HR 0.51 (0.42-0.63)]. Consistent results were obtained when the laboratory data were included in the propensity score for matching.
Long-term aspirin use significantly reduced the incidence of HCC and overall mortality without increasing gastrointestinal bleeding in cirrhotic patients.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37296908</pmid><doi>10.3390/cancers15112946</doi><orcidid>https://orcid.org/0000-0002-2756-678X</orcidid><orcidid>https://orcid.org/0000-0002-0907-1505</orcidid><orcidid>https://orcid.org/0000-0002-5083-8851</orcidid><orcidid>https://orcid.org/0000-0001-7171-3532</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antiplatelet therapy Aspirin Bleeding Cancer therapies Cirrhosis Comorbidity Diabetes Hepatitis B Hepatitis C Hepatocellular carcinoma Hepatoma Hospitalization Hypertension Laboratories Liver cancer Liver cirrhosis Liver diseases Medical research Medicine, Experimental Metastasis Mortality Patient outcomes Patients Risk factors Tumors |
| title | Daily Aspirin Reduced the Incidence of Hepatocellular Carcinoma and Overall Mortality in Patients with Cirrhosis |
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