Table 3 Sensitivity analyses – univariate and multivariate hazard ratios for association between de novo post-diagnostic statin use and mortality

From: De novo post-diagnosis statin use, breast cancer-specific and overall mortality in women with stage I–III breast cancer

      

All-cause mortality

Breast cancer-specific mortality

De novo post-diagnostic statin exposure definitions

N

Years to treatment initiation (median)

Years on treatment (median)

On-treatment exposure intensity (mean %)

Follow-up (person years)

Deaths (rate) a

Univariate HR (95% CI)

Multivariate HR (95% CI) b

Deaths (rate) a

Univariate HR (95% CI)

Multivariate HR (95% CI) b

Sensitivity analysis: yes/no exposure lagged by 0, 1, 3 and 4 years

 Statin exposure – yes/no (lag 0 years)

           

 Non-user

3038

—

—

—

18 339

909 (49.6)

Ref

Ref

562 (30.7)

Ref

Ref

 Statin user

1205

2.5

5.7

85.6

4496

230 (51.5)

0.94 (0.81, 1.09)

1.01 (0.87, 1.18)

107 (23.9)

0.78 (0.63, 0.97)

0.86 (0.69, 1.07)

 Statin exposure – yes/no (lag 1 year)

           

 Non-user

3058

—

—

—

15 291

804 (52.6)

Ref

Ref

482 (31.5)

Ref

Ref

 Statin user

1033

2.3

6.7

86.0

3354

183 (54.6)

0.99 (0.84, 1.17)

1.06 (0.89, 1.25)

85 (25.3)

0.85 (0.67, 1.08)

0.94 (0.74, 1.19)

 Statin exposure – yes/no (lag 3 years)

           

 Non-user

2425

—

—

—

9776

564 (57.7)

Ref

Ref

308 (31.5)

Ref

Ref

 Statin user

640

1.9

6.1

85.9

1686

93 (55.2)

0.99 (0.79, 1.25)

1.06 (0.84, 1.33)

40 (23.7)

0.87 (0.62, 1.22)

0.96 (0.68, 1.34)

 Statin exposure – yes/no (lag 4 years)

           

 Non-user

2046

—

—

—

7540

427 (56.6)

Ref

Ref

221 (29.3)

Ref

Ref

 Statin user

492

1.7

6.1

85.7

1117

59 (52.8)

0.96 (0.73, 1.27)

0.99 (0.74, 1.31)

25 (22.4)

0.88 (0.57, 1.35)

0.95 (0.62, 1.46)

Sensitivity analysis: high-intensity exposure⩾80% for ⩾24 consecutive months c

Non-user

2759

—

—

—

12 369

692 (55.9)

Ref

Ref

398 (32.2)

Ref

Ref

Statin user – low intensity

480

2.5

1.6

82.8

1613

83 (51.5)

0.91 (0.72, 1.14)

0.96 (0.76, 1.21)

37 (22.9)

0.76 (0.54, 1.06)

0.84 (0.60, 1.18)

Statin user – high intensity

357

1.8

8.5

91.0

813

45 (55.3)

1.00 (0.73, 1.36)

1.07 (0.78, 1.47)

19 (23.4)

0.88 (0.55, 1.42)

1.02 (0.63, 1.65)

Sensitivity analysis: no statin exposure in 3 years prior to diagnosis

 Statin exposure – yes/no c

           

 Non-user

2670

—

—

—

12 096

677 (56.0)

Ref

Ref

392 (32.4)

Ref

Ref

 Statin user

796

2.2

6.7

86.1

2307

124 (53.8)

0.96 (0.78, 1.17)

1.03 (0.84, 1.25)

55 (23.8)

0.82 (0.61, 1.10)

0.90 (0.67, 1.21)

  1. Abbreviations: CI=confidence interval; HR=hazard ratio; Ref=referent group.
  2. aDeaths per 1000 person years.
  3. bAdjusted for age at diagnosis (years); smoking status (never, past, current and unspecified); comorbidity score, tumour stage (I, IIa, IIb, IIIa and IIIb–c); tumour grade (low, intermediate, high and unspecified); ER, PR and HER2 receptor status (positive, negative and unspecified); chemotherapy in year post diagnosis (yes, no); anti-oestrogen therapy in year post diagnosis (yes, no); aspirin, bisphosphonate, NSAID and anti-diabetic medication use (yes, no).
  4. cStatin exposure lagged by 2 years in analysis.
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