cardiovascular-agents and Lung-Neoplasms

Although primarily a lung disease, chronic obstructive pulmonary disease (COPD) is now recognized to have extrapulmonary effects on distal organs, the so-called systemic effects and comorbidities of COPD. Skeletal muscle dysfunction, nutritional abnormalities including weight loss, cardiovascular complications, metabolic complications, and osteoporosis, among others, are all well-recognized associations in COPD. These extrapulmonary effects add to the burden of mortality and morbidity in COPD and therefore should be actively looked for, assessed, and treated.

Topics: Anemia; Cardiovascular Agents; Cardiovascular Diseases; Humans; Lung Neoplasms; Muscular Atrophy; Osteoporosis; Pulmonary Disease, Chronic Obstructive

Topics: Aged; Cardiovascular Agents; Female; Humans; Intraoperative Complications; Lung Neoplasms; Myocardial Infarction; Preoperative Care; Risk Assessment

Chronic obstructive pulmonary disease (COPD) is commonly associated with multiple comorbidities. Our objective was to assess the prevalence of comorbidities in patients with COPD and to relate their prevalence to the severity of the disease by using a large German health care database. Based on the retrospective analysis of a two-year (2013-2014) database from the German Statutory Health Insurance system, we obtained a representative sample of 4,075,493 german insurants. This sample included 146,141 patients with COPD (age: ≥35 years). To these patients, we matched 1:1 by age and gender randomly selected non-COPD controls. We assessed the comorbidities and the use of cardiovascular drugs, and examined COPD subgroups according to lung function (ICD-10-coded FEV1) and the treatment with long-acting inhaled bronchodilators. Compared to non-COPD, patients with COPD had a higher prevalence of hypertension, congestive heart failure, diabetes, gastroesophageal reflux disease, chronic kidney disease, osteoporosis, psychiatric disease and lung cancer, and used more cardiovascular-related drugs. However, the prevalence of comorbidities did not correlate to the severity of airflow limitation. The results of this sizeable nationwide survey support the concept that individuals with COPD need careful evaluation regarding comorbidities. This can already be of relevance in patients with mild to moderate airflow limitation.. Comorbidities in COPD have a complex relationship with disease severity, requiring a comprehensive therapy approach.

Topics: Aged; Bronchodilator Agents; Cardiovascular Agents; Cardiovascular Diseases; Comorbidity; Diabetes Mellitus; Female; Forced Expiratory Volume; Gastroesophageal Reflux; Germany; Heart Failure; Humans; Hypertension; Lung Neoplasms; Male; Middle Aged; Osteoporosis; Prevalence; Pulmonary Disease, Chronic Obstructive; Renal Insufficiency, Chronic; Retrospective Studies; Severity of Illness Index

Preclinical and epidemiologic studies suggest that receipt of some cardiac medications such as angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, or aspirin may have antiproliferative effects in several types of cancer. The aim of this study was to estimate survival outcomes in patients receiving incidental cardiac medications during treatment for lung cancer, and to compare outcomes with those patients not receiving these medications.. We retrospectively reviewed 673 patients who had received definitive radiotherapy for stage III non-small-cell lung cancer (NSCLC). Cox proportional hazard models were used to assess associations between receipt of ACEIs, ARBs, β-blockers, or aspirin and locoregional progression-free survival (LRPFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS).. Multivariate analyses showed that ACEI receipt was associated with poorer LRPFS but had no effect on DMFS, DFS, or OS. Aspirin receipt was associated only with improved DMFS, and β-blocker receipt was associated with improved DMFS, DFS, and OS.. Incidental receipt of ACEIs was associated with a higher prevalence of local failure, whereas receipt of either β-blockers or aspirin had protective effects on survival outcomes in this large group of patients with lung cancer. This finding warrants further clinical and preclinical exploration, as it may have important implications for treating patients with lung cancer who are also receiving cardiac medications.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Cardiovascular Agents; Disease-Free Survival; Female; Humans; Lung Neoplasms; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; Proportional Hazards Models; Retrospective Studies; Survival Rate; Treatment Failure

In a recent article published in The Lancet, investigators studied the impact of daily aspirin use on subsequent cancer deaths. Utilizing data from more than 25,000 patients enrolled in 8 large trials, which were originally intended to study the impact of daily aspirin use on the incidence of cardiovascular events, the authors found a substantial decrease in risk of fatal solid organ malignancies. In particular, the risk reduction was specific to adenocarcinomas. The findings from this study are highly relevant to the thoracic surgeon, with adenocarcinomas of the lung and esophagus among those tumors demonstrating the most profound risk reduction.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Anticarcinogenic Agents; Aspirin; Cardiovascular Agents; Cardiovascular Diseases; Esophageal Neoplasms; Humans; Incidence; Lung Neoplasms; Neoplasms; Preventive Health Services; Risk Assessment; Risk Factors