Association between daily aspirin therapy and risk of hepatocellular carcinoma according to metabolic risk factor burden in non-cirrhotic patients with chronic hepatitis B
- Authors
- Lee, Cheol-Hyung; Lee, Yun Bin; Moon, Hyemi; Chung, Jong-Won; Cho, Eun Ju; Lee, Jeong-Hoon; Yu, Su Jong; Kim, Yoon Jun; Lee, Juneyoung; Yoon, Jung-Hwan
- Issue Date
- Oct-2023
- Publisher
- WILEY
- Keywords
- bleeding; HBV; liver cancer; metabolic syndrome; survival
- Citation
- ALIMENTARY PHARMACOLOGY & THERAPEUTICS, v.58, no.7, pp 704 - 714
- Pages
- 11
- Indexed
- SCIE
SCOPUS
- Journal Title
- ALIMENTARY PHARMACOLOGY & THERAPEUTICS
- Volume
- 58
- Number
- 7
- Start Page
- 704
- End Page
- 714
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63773
- DOI
- 10.1111/apt.17643
- ISSN
- 0269-2813
1365-2036
- Abstract
- Background: Several studies have demonstrated chemopreventive effects of aspirin against hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).Aims: To investigate the associations of aspirin use with risks of HCC, liver-related mortality, and major bleeding according to metabolic risk factor burden among non-cirrhotic patients with CHBMethods: Using the Korean National Health Insurance Service database, we identified 282,611 non-cirrhotic adults with CHB. Data on obesity, diabetes, high blood pressure, and hypercholesterolemia were collected. Subjects were stratified into lower and higher metabolic risk groups (& LE;2 and & GE;3 risk factors, respectively). Propensity score-matched cohorts of aspirin users and non-users were generated. Risks of HCC, liver-related death and major bleeding were analyzed.Results: During the median follow-up of 7.4 years, positive associations between metabolic risk factor burden and outcomes were verified (all p(trend) < 0.001). In the lower metabolic risk group (13,104 pairs), the association between aspirin use and HCC risk was not significant after multivariable adjustment (adjusted subdistribution hazard ratio [aSHR]: 0.93; 95% CI: 0.84-1.03); however, aspirin use was associated with elevated major bleeding risk (aSHR: 1.22; 95% CI: 1.08-1.39). In the higher metabolic risk group (2984 pairs), aspirin use was associated with reduced risks of HCC (aSHR: 0.72; 95% CI: 0.57-0.91) and liver-related mortality (aSHR: 0.69; 95% CI: 0.50-0.96) without an increase in risk of major bleeding (aSHR: 1.02; 95% CI: 0.79-1.32).Conclusions: Aspirin therapy was associated with reduced risks of HCC and liver-related death without excess risk of major bleeding, in non-cirrhotic patients with CHB who had a higher metabolic risk factor burden.
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Collections - 1. Basic Science > Department of Biostatistics > 1. Journal Articles
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