Statin Therapy Improves Multiple Myeloma (MM) Specific Surviva

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 879-879
Author(s):  
Kristen M. Sanfilippo ◽  
Jesse Keller ◽  
Suhong Luo ◽  
Brian F. Gage ◽  
Gerald Moskowitz ◽  
...  
Keyword(s):  
Heart Disease ◽  
Propensity Score ◽  
Statin Therapy ◽  
Propensity Score Analysis ◽  
Lipid Lowering ◽  
Defined Daily Dose ◽  
Immortal Time Bias ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Statin Use

Abstract Background: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are widely used for treatment of dyslipidemia and prevention of coronary heart disease. Recently, a multicenter clinical trial found discontinuation of statin therapy in patients with estimated survival of < 1 year had no significant impact on mortality or cardiovascular outcomes [Kutner JAMA Int Med 2015]. In this trial, approximately 50% of patients had cancer as their primary diagnosis. However, statin use has been associated with improved cancer-specific survival in several malignancies. Preclinical evidence suggests that this effect may be independent of the lipid lowering properties. In addition, in the case of MM, statins influence similar pathways as the bisphosphonates. To understand the putative benefit of statins in MM, we evaluated the association between statin use and mortality in a large cohort of MM patients. Methods: We identified patients diagnosed with MM in the Veterans Administration Cancer Registry from September 1, 1999 to December 31, 2009 and followed them through October 2014. We excluded patients who did not receive MM directed therapy within 6 months of diagnosis or who died within 6 months of diagnosis. We defined statin use as the presence of any prescription for a statin on or after the date of MM diagnosis. To standardize statin utilization, we calculated the defined daily dose (DDD), which allows normalization of dose and potency amongst differing statins. The DDD is the assumed average maintenance dose per day for a drug used for its main indication. To reduce immortal time bias, we assessed statin use as a time varying covariate. Cox proportional hazards regression modeling assessed the association between statin use, overall mortality, and cause-specific mortality, while controlling for known MM prognostic factors. Propensity score analyses balanced baseline differences between statin users and non-users. Results: The cohort included a total of 3,069 patients, of whom 1,334 received statin therapy. Statin use was associated with a significant decrease in all-cause mortality (adjusted HR (aHR) 0.81, 95% CI: 0.73-0.90). Stratifying statin use by DDD, MM patients receiving <365 days of statins had a 14% reduction in all-cause mortality (aHR 0.86, 95%: CI 0.76-0.97), while patients receiving ≥365 days of statin therapy had a 24% reduction in mortality (aHR 0.76; 95% CI: 0.66-0.87). When looking at MM-specific mortality, statin use was associated with a 19% reduction in death from MM (aHR 0.81, 95% CI: 0.71-0.93). Stratifying statin use by DDD, we found that patients receiving <365 days of statin use had a 15% reduction in MM-specific mortality (aHR 0.85, 95%: CI 0.72-0.99), while patients receiving ≥365 days of statin therapy had a 25% reduction in mortality (aHR 0.75; 95% CI: 0.62-0.91). At baseline, statin users were more likely to be older, obese, Caucasian, and have more medical comorbidities (diabetes, chronic kidney disease, ischemic heart disease, cerebrovascular disease, peripheral vascular disease, and dyslipidemia). These differences were well balanced in the propensity score analysis, in which statin use remained significantly associated with a reduction in mortality (aHR 0.60; 95% CI: 0.52-0.70). Conclusion: In this cohort of patients with MM, statin therapy was significantly associated with a reduction in both all-cause and MM-specific mortality. These findings argue against discontinuing statin therapy in patients with MM, including those with a prognosis of < 1 year. Disclosures Sanfilippo: Amgen: Speakers Bureau.

The relationship between statins and breast cancer prognosis varies by statin type and exposure time: A meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21606-e21606
Author(s):  
Binliang Liu ◽  
Zongbi Yi ◽  
Xiuwen Guan ◽  
Fei Ma ◽  
Yi-Xin Zeng
Keyword(s):  
Breast Cancer ◽  
Protective Effect ◽  
Breast Cancer Prognosis ◽  
Cancer Prognosis ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Relationship ◽  
Statin Use

e21606 Background:Breast cancer is the most common cancer in females. The effects of statins on breast cancer prognosis have long been controversial, so it is important to investigate the relationship between statin type, exposure time, and breast cancer prognosis. This study sought to explore the effect of statins on breast cancer prognosis. Methods:We searched the MEDLINE, EMBASE, Cochrane Library between October 15, 2016 and January 20, 2017. Searches combined the terms “breast neoplasms[MeSH]”, “statins”, “prognosis” or “survival” or “mortality” with no limit on publication date. Data were analyzed using Stata/SE 11.0. Results: 7 studies finally met the selection criteria and 197,048 included women. Overall statin use was associated with lower cancer-specific mortality and all-cause mortality (HR 0.73, 95% CI 0.59-0.92, P = 0.000 and HR 0.72, 95% CI 0.58-0.89, P = 0.000). Lipophilic statins were associated with decreased breast cancer-specific and all-cause mortality (HR 0.57, 95% CI 0.46-0.70, P = 0.000 and HR 0.57, 95% CI 0.48-0.69, P = 0.000); however, hydrophilic statins were weakly protective against only all-cause mortality (HR 0.79, 95% CI 0.65-0.97, P = 0.132) and not breast cancer-specific mortality (HR 0.94, 95% CI 0.76-1.17, P = 0.174). Of note, more than four years of follow-up did not show a significant correlation between statin use and cancer-specific mortality or all-cause mortality (HR 0.84, 95% CI 0.71-1.00, P = 0.616 and HR 0.95, 95% CI 0.75-1.19, P = 0.181), while groups with less than four years of follow-up still showed the protective effect of statins against cancer-specific mortality and all-cause mortality (HR 0.62, 95% CI 0.44-0.87, P = 0.000 and HR 0.61, 95% CI 0.45-0.80, P = 0.000). Conclusions:Although statins can reduce breast cancer patient mortality, the benefit appears to be constrained by statin type and follow-up time. Lipophilic statins showed a strong protective function in breast cancer patients, while hydrophilic statins only slightly improved all-cause mortality. Finally, the protective effect of statins could only be observed in groups with less than four years of follow-up.

scholarly journals Statin therapy and mortality among new long-term care residents in Ontario, Canada: the contribution of clinical assessment data to a population-based cohort study

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Michael Campitelli ◽  
Susan Bronskill ◽  
Vasily Giannakeas ◽  
Andrew Morris ◽  
Colleen Maxwell ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Statin Therapy ◽  
Administrative Data ◽  
Long Term Care ◽  
Assessment Data ◽  
Term Care ◽  
Health Administrative Data ◽  
Statin Use

ABSTRACTObjectiveThere is limited evidence from randomized trials and observational studies to guide clinical practice regarding the use of statins in long-term care (LTC); the effectiveness of statins among those with limited life expectancy is not clear and there is concern that the risk of drug-related adverse events might outweigh any benefit. We examined the impact of initiating statin therapy on mortality for patients newly admitted to LTC. ApproachPopulation-based health administrative data from Ontario, Canada were used to conduct a retrospective cohort study of newly admitted LTC residents, aged 66+ years and no statin use in the previous year, between January 1 2011 and December 31 2014. This cohort was linked to Resident Assessment Instrument (interRAI) data to capture clinical and functional characteristics (including frailty, activities of daily living, and cognitive function). The primary exposure was statin use within 30 days following LTC entry; residents who died or did not receive an interRAI assessment within 30 days were excluded. A propensity score for receiving statins was computed using resident demographic, clinical and functional characteristics. We matched exposed to unexposed patients on the basis of age (±1 year), sex, prior myocardial infarction(MI)/stroke hospitalization, frailty and propensity score (±0.2 standard deviations). Patients were followed in an intention-to-treat manner from the end of the exposure window until the earliest of death or March 31 2015. Cox regression was used to compare mortality between the study groups. ResultsWe identified 39,560 newly admitted LTC residents aged 66+ years with no statin use in the previous year, of which 1,953 (4.9%) were prescribed a statin within 30 days of LTC entry. Propensity score matching resulted in 1,710 pairs of exposed and unexposed patients. In the matched cohort, those receiving statins had a lower rate of mortality compared with those not receiving statins (Hazard Ratio 0.77; 95% Confidence Interval [CI] 0.70-0.85). In pre-specified subgroup analyses, the association between statin use and reduced mortality persisted among those with and without a prior MI/stroke hospitalization and among those categorized as frail and not frail. ConclusionOur data suggest initiating statins may be beneficial in reducing mortality risk among LTC residents, despite the complexity and advanced age of the patients. By linking rich resident-level health and functional assessment data with health administrative data we were able to characterize the association between demographic and clinical characteristics (including frailty) and exposure to statins more fully than with administrative data alone.

scholarly journals Cardiovascular events as a № 1 killer. Pharmacotherapy of coronary heart disease

2020 ◽  
pp. 317-319
Author(s):  
V.O. Shumakov
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Statin Therapy ◽  
High Intensity ◽  
Lipid Lowering ◽  
Pcsk9 Inhibitors ◽  
Basic Therapy ◽  
Coronary Syndrome

Background. Computed tomography studies of ancient mummies have shown that the representatives of all ancient civilizations had atherosclerosis. It is now known that the severity of atherosclerosis depends on the content of non-high density lipoprotein cholesterol (nHDL-C) and age. A detailed analysis of global statistics on mortality from cardiovascular disease (CVD) found that the mortality of Ukrainian men and women is 14 and 23 times higher than the French counterparts. However, since the beginning of the 21st century, almost all European middle-income countries have reached a decline in mortality, probably due to the implementation of programs to combat hypertension and dyslipidemia. Objective. To describe modern pharmacotherapy of coro- nary heart disease. Materials and methods. Analysis of the literature on this topic. Results and discussion. A significant proportion of deaths are due to acute coronary heart disease. Long-term treat- ment of patients after myocardial infarction should include control of risk factors and lifestyle changes, antithrombotic therapy, use of b-blockers, angiotensin-converting enzyme inhibitors, mineralocorticoid receptor inhibitors, lipid-lowering therapy. Serial intravascular ultrasound studies have shown that high-intensity statin therapy has reduced the burden of atherosclerotic plaques in non-infarct-dependent arteries (from 67.5 to 58.5 %). In addition to slowing atherosclerosis, statins also increase plaque calcification and improve its stability. Medium-intensity statin therapy reduces low-density lipoprotein cholesterol (LDL-C) by 30 %, high-intensity statin therapy – by 50 %, high-intensity statin therapy in combination with ezetimibe – by 65 %, PCSK9 inhibitors – by 60 %, high-intensity statin and PCSK9 inhibitors – by 75 %, highintensity statin therapy in combination with PCSK9 inhibitors and ezetimibe – by 85 %. The FOURIER study confirmed the high efficacy of PCSK9 inhibitors in reducing LDL-C in high-risk patients. The hazard ratio for the composite endpoint (cardiovascular death, myocardial infarction, CVD hospitaliza- tion, need for revascularization) for evolocumab compared to placebo was 0.85 (p<0.0001). The ODYSSEY OUTCOMES study found similar results for alirocumab. In general, statin therapy with a decrease in LDL-C of more than 50 % and/or to a level <1.4 mmol/L is recommended for all patients with acute coro- nary syndrome without ST segment elevation. If maximal dose of statins does not allow to reach such results in 4-6 weeks, it is recommended to add ezetimibe. In the absence of effect on the background of treatment with this combination, it is necessary to add PCSK9 inhibitors. In the context of the COVID-19 pandemic, it is necessary to continue taking all cardiac drugs, including statins. There is evidence that statins help to reduce the severity of viral pneumonia and to decrease the mortality from acute respiratory viral infections. Statins have a number of pleiotropic effects: anti-inflammatory, immunomodulatory, antioxidant, and antithrombotic. All of them are favorable for coronavirus infection. In addition to statins, in coronary heart disease it is advisable to prescribe metabolic therapy. Tivorel (“Yuria-Pharm”) is indicated for coronary heart disease, acute myocardial infarction and after a heart attack. Already on the third day of treatment of acute coronary syn- drome, the effectiveness of basic therapy in combination with Tivorel (100 ml per day) exceeds the effectiveness of basic therapy only in reducing the incidence of anginal pain by 35 % and the use of opioid analgesics in case of pain by 38 % (Vakaliuk I.P., 2015). Foreign studies confirm that L-arginine reduces the symptoms of angina and improves the quality of life of patients, reduces blood pressure and pulmonary artery pressure in patients with pulmonary hypertension. Apart from that, L-carnitine helps to increase the ejection fraction and re- duce the area of myocardial infarction, eliminate arrhythmias, reduce cardiovascular mortality. Tivorel has a beneficial effect on left ventricular remodeling. After 10 days of basic therapy in combination with Tivorel, the end systolic volume of the left ventricle in post-infarction patients is reduced by 16 %, and in the group of basic therapy – by 3 %. 32-80 % of CVD patients have mental disorders that increase the risk of death. Lodixem (“Yuria-Pharm”) is a specialized cardioprotector with a daytime tranquilizer effect. The effectiveness of Lodixem in the combined therapy of stable angina, hypertension, heart failure, acute coronary syndrome has been proven. Conclusions. 1. Long-term therapy of patients after myo- cardial infarction should include control of risk factors and lifestyle changes, antithrombotic therapy, use of b-blockers, angiotensin-converting enzyme inhibitors, mineralocorticoid receptor inhibitors, and lipid-lowering therapy. 2. All patients with acute coronary syndrome without ST segment elevation are recommended statin therapy with a decrease in LDL-C by more than 50 % and/or to a level <1.4 mmol/L. 3. In the context of the COVID-19 pandemic, it is necessary to continue taking all cardiac drugs, including statins. 4. Tivorel reduces the incidence of anginal pain, the use of opioid analgesics for pain, and has a beneficial effect on left ventricular remodeling. 5. Lodixem (a specialized cardioprotector with the effect of a daytime tranquilizer) is effective in the treatment of stable angina, hypertension, heart failure, acute coronary syndrome.

scholarly journals CMR analysis of the cardioprotective effects of chronic statin therapy prior to first STEMI: a propensity score analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G Mendieta Badimon ◽  
M Calvo ◽  
J Guzman ◽  
P Perez ◽  
M Alamar ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Analysis ◽  
Smoking Status ◽  
Statin Treatment ◽  
Left Ventricular ◽  
Prior Treatment ◽  
Lipid Lowering ◽  
Cardioprotective Effects ◽  
The Impact

Abstract Background In addition to their lipid-lowering properties, statins possess cardioprotective effects. However, the impact of the latter on acute cardioprotection and adverse left ventricular (LV) remodelling following ST-elevation myocardial infarction (STEMI) have not been investigated through cardiac magnetic resonance (CMR) analysis to date. Purpose To investigate the cardioprotective effects of chronic oral statin treatment prior to first STEMI. Methods The study included 1236 patients with a first STEMI and a CMR performed during the index admission. Among them, 923 underwent a second CMR at 6 months follow-up. The effects of chronic oral statin treatment prior to STEMI on acute infarct size (IS) as a percentage of LV mass, LV ejection fraction (LVEF), microvascular obstruction (MVO), and changes in LV end-diastolic volume (EDVi) and end-systolic volume indexes (ESVi)] at 6 months were evaluated. A propensity score to receive treatment prior to STEMI with statins was calculated based on the inverse probability of treatment weighting (IPTW) from the following parameters: age on admission, sex, smoking status, type 2 diabetes, hypertension, family history of coronary artery disease, current co-treatments (ACEis/ARBs and/or beta-blockers), heart rate (HR), blood pressure (BP) and creatinine levels on admission, and pre-PCI TIMI flow in the culprit artery. Results were stratified according to a symptom-to-balloon time (S2Bt) ≤ or &gt;3 hours. Results The study population's median age was 59 years (IQR 50–68), 16.3% were women; 18.9% were receiving treatment with statins prior to STEMI (table 1). Despite no effect on MVO occurrence (OR: 0.81 [0.60; 1.09], p=0.166), prior treatment with statins was associated with a reduction in IS (18.43% [16.67; 20.19] vs 21.50% [20.67; 22.34], p=0.002), particularly among subjects with ≤3 hours of S2Bt. Accordingly, prior treatment with statins conferred a benefit in mean baseline LVEF (50.23% [48.73; 51.73] vs 48.15% [47.43; 48.87], p=0.014). At 6 months, treatment with statins prior to STEMI blunted the changes in EDVi and ESVi, but only among patients with ≤3 hours of S2Bt (table 2). In addition, a reduction in the probability of adverse LV remodelling, defined as an increase in ESVi &gt;10%, was observed in statin pre-treated patients (OR: 0.67 [0.45; 0.99], p=0.043). Conclusion Treatment with statins before STEMI is associated with improved indexes of cardioprotection as assessed by CMR, particularly among subjects with S2Bt ≤3 hours. Those effects seem to have an impact in limiting adverse LV remodelling as early as 6 months follow-up, and a greater than 10% change in ESVi. These findings warrant further and prospective evaluation of the potential cardioprotective effects of chronic oral statin treatment prior to STEMI. FUNDunding Acknowledgement Type of funding sources: Other. Main funding source(s): This study was partially funded by several grants from Fundaciό La Marato TV3 (2015 30 31 32), Instituto de Salud Carlos III (FIS15/00531) and La Caixa Banking Foundation (HR17-00527).

Abstract 9: Clinical Effectiveness of Statin Therapy after Ischemic Stroke: Primary Results from the PROSPER Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Emily C O'Brien ◽  
Melissa A Greiner ◽  
Ying Xian ◽  
Gregg C Fonarow ◽  
DaiWai M Olson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Statin Therapy ◽  
Real World ◽  
Hemorrhagic Stroke ◽  
World Population ◽  
Stroke Patients ◽  
Post Discharge ◽  
All Cause Mortality ◽  
Lower Hazard ◽  
Statin Use

Background: Evidence for statin use comes primarily from select clinical trial populations that are often younger without comorbidities. Stroke patients and their caregivers are in need of real-world effectiveness data to better inform decision-making on statin use after stroke. Methods: PROSPER is a PCORI-funded research program designed with stroke survivors to evaluate the effectiveness of therapies post-stroke. We linked data from Get With The Guidelines-Stroke patients >65 years of age to Medicare claims to capture post-discharge outcomes. Primary outcomes prioritized by patients were: 1) Home time (days alive and out of acute or post-acute care) and 2) Major adverse cardiovascular events (MACE). Secondary outcomes included all-cause mortality, all-cause readmission, CV readmission, and hemorrhagic stroke. We used negative binomial and Cox models to evaluate discharge statins and outcomes with inverse probability weighting (IPW) to adjust for baseline differences by treatment group. Results: Of 77,468 statin-naïve ischemic stroke patients hospitalized from 2007-2011, n=54,991 (71%) were discharged on statin therapy. Compared with those not receiving a statin, patients receiving a statin were younger and more likely to be smokers. Unadjusted rates of MACE, mortality and CV readmission within 2 years were lower for statin patients compared with those not receiving a statin. After IPW adjustment, statin therapy was associated with 28 more days of home time in the 2-year post-discharge period (P <.001), 9% lower hazard of MACE (P <.001), 16% lower hazard of mortality (P <.001), and 7% lower hazard of readmission (P <.001). Statin use was not associated with increased risk of hemorrhagic stroke (P=0.56). Conclusions: In a real-world population of older statin-naïve ischemic stroke patients, discharge statin therapy was associated with more days spent at home during the 2-year period after hospitalization and lower risk of both MACE and all-cause mortality.

scholarly journals Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study

BMJ ◽  
2020 ◽  
pp. m4266
Author(s):  
Camilla Ditlev Lindhardt Johannesen ◽  
Anne Langsted ◽  
Martin Bødtker Mortensen ◽  
Børge Grønne Nordestgaard
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Prospective Cohort ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Low Density ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Specific Mortality

Abstract Objective To determine the association between levels of low density lipoprotein cholesterol (LDL-C) and all cause mortality, and the concentration of LDL-C associated with the lowest risk of all cause mortality in the general population. Design Prospective cohort study. Setting Denmark; the Copenhagen General Population Study recruited in 2003-15 with a median follow-up of 9.4 years. Participants Individuals randomly selected from the national Danish Civil Registration System. Main outcome measures Baseline levels of LDL-C associated with risk of mortality were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. Main outcome was all cause mortality. Secondary outcomes were cause specific mortality (cardiovascular, cancer, and other mortality). Results Among 108 243 individuals aged 20-100, 11 376 (10.5%) died during the study, at a median age of 81. The association between levels of LDL-C and the risk of all cause mortality was U shaped, with low and high levels associated with an increased risk of all cause mortality. Compared with individuals with concentrations of LDL-C of 3.4-3.9 mmol/L (132-154 mg/dL; 61st-80th centiles), the multivariable adjusted hazard ratio for all cause mortality was 1.25 (95% confidence interval 1.15 to 1.36) for individuals with LDL-C concentrations of less than 1.8 mmol/L (<70 mg/dL; 1st-5th centiles) and 1.15 (1.05 to 1.27) for LDL-C concentrations of more than 4.8 mmol/L (>189 mg/dL; 96th-100th centiles). The concentration of LDL-C associated with the lowest risk of all cause mortality was 3.6 mmol/L (140 mg/dL) in the overall population and in individuals not receiving lipid lowering treatment, compared with 2.3 mmol/L (89 mg/dL) in individuals receiving lipid lowering treatment. Similar results were seen in men and women, across age groups, and for cancer and other mortality, but not for cardiovascular mortality. Any increase in LDL-C levels was associated with an increased risk of myocardial infarction. Conclusions In the general population, low and high levels of LDL-C were associated with an increased risk of all cause mortality, and the lowest risk of all cause mortality was found at an LDL-C concentration of 3.6 mmol/L (140 mg/dL).

scholarly journals Impact of Racial Disparities on All-Cause Mortality in Patients With Tumors of the Spinal Cord or Spinal Meninges: A Propensity-Score Analysis

2021 ◽  
pp. 219256822110338
Author(s):  
Aladine A. Elsamadicy ◽  
Isaac Freedman ◽  
Andrew B. Koo ◽  
Wyatt B. David ◽  
Benjamin C. Reeves ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Regression Analysis ◽  
African American ◽  
Propensity Score ◽  
Nearest Neighbor ◽  
Proportional Hazards ◽  
Propensity Score Analysis ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
All Cause Mortality

Study Design: Retrospective cohort study. Objective: The influence that race has on mortality rates in patients with spinal cord tumors is relatively unknown. The aim of this study was to investigate the influence of race on the outcomes of patients with primary malignant or nonmalignant tumors of the spinal cord or spinal meninges. Methods: The Surveillance, Epidemiology, and End Results (SEER) Registry was used to identify all patients with a code for primary malignant or nonmalignant tumor of the spinal cord (C72.0) or spinal meninges (C70.1) from 1973 through 2016. Racial groups (African-American/Black vs. White) were balanced using propensity-score (PS) matching using a non-parsimonious 1:1 nearest neighbor matching algorithm. Overall survival (OS) estimates were obtained using the Kaplan-Meier method and compared across non-PS-matched and PS-matched groups using log-rank tests. Associations of survival with clinical variables was assessed using doubly robust Cox proportional-hazards (CPH) regression analysis. Results: There were a total of 7,498 patients identified with 648 (6.8%) being African American. African-American patients with primary intradural spine tumors were more likely to die of all causes than were White patients in both the non-PS-matched [HR: 1.26, 95% CI: (1.04, 1.51), P = 0.01] and PS-matched cohorts [HR: 1.64, 95% CI: (1.28, 2.11), P < 0.0001]. On multivariate CPH regression analysis age at diagnosis [HR: 1.03, 95% CI: (1.02, 1.05), P < 0.0001], race [HR: 1.82, 95% CI: (1.22, 2.74), P = 0.004), and receipt of RT [HR: 2.62, 95% CI: (1.56, 4.37), P = 0.0002) were all significantly associated with all-cause mortality, when controlling for other demographic, tumor, and treatment variables. Conclusions: Our study provides population-based estimates of the prognosis for patients with primary malignant or nonmalignant tumors of the spinal cord or spinal meninges and suggests that race may impact all-cause mortality.

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