Evidence map›Paper›PMID 39134317›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2024

Renin-angiotensin system inhibitors and risk of hepatocellular carcinoma among patients with hepatitis B virus infection.

Ruixuan Chen, Shiyu Zhou, Jiao Liu, Lu Li, Licong Su, Yanqin Li, Chuyao Fang, Xiaodong Zhang, Fan Luo, Qi Gao and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Chemoprevention of hepatocellular carcinoma.Hepatology communications · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Ruixuan ChenState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Shiyu ZhouState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Jiao LiuState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Lu LiState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Licong SuState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Yanqin LiState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Chuyao FangState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Xiaodong ZhangState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Fan LuoState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Qi GaoState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Yuxin LinState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Zhixin GuoState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Lisha CaoState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China.
Xin XuState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China niesheng0202@126.com xux007@163.com.
Sheng NieState Key Laboratory of Organ Failure Research (Chen, Zhou, Liu, Su, Y. Li, Zhang, Luo, Gao, Lin, Guo, Cao, Xu, Nie), National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Oncology, Nanfang Hospital (L. Li, Fang), Southern Medical University, Guangzhou, Guangdong, China niesheng0202@126.com xux007@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatitis B virus (HBV) infection is a common cause of liver-related morbidity and mortality. Evidence suggests that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) decrease liver fibrosis, an intermediate step between liver injury and hepatocellular carcinoma (HCC). Our aim was to investigate the association between the use of ACEIs and ARBs on incident HCC and liver-related mortality among patients with HBV infection.

methodsWe conducted a population-based study on a new-user cohort of patients seen at 24 hospitals across China. We included adult patients with HBV infection who started ACEIs or ARBs (ACEIs/ARBs), or calcium channel blockers or thiazide diuretics (CCBs/THZs) from January 2012 to December 2022. The primary outcome was incident HCC; secondary outcomes were liver-related mortality and new-onset cirrhosis. We used propensity score matching and Cox proportional hazards regression to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of study outcomes.

resultsAmong 32 692 eligible patients (median age 58 [interquartile range (IQR) 48-68] yr, and 18 804 male [57.5%]), we matched 9946 pairs of patients starting ACEIs/ARBs or CCBs/THZs. During a mean follow-up of 2.3 years, the incidence rate of HCC per 1000 person-years was 4.11 and 5.94 among patients who started ACEIs/ARBs and CCBs/THZs, respectively, in the matched cohort. Use of ACEIs/ARBs was associated with lower risks of incident HCC (HR 0.66, 95% CI 0.50-0.86), liver-related mortality (HR 0.77, 95% CI 0.64-0.93), and new-onset cirrhosis (HR 0.81, 95% CI 0.70-0.94).

interpretationIn this cohort of patients with HBV infection, new users of ACEIs/ARBs had a lower risk of incident HCC, liver-related mortality, and new-onset cirrhosis than new users of CCBs/THZs.

Indexed as

Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCarcinoma, HepatocellularLiver NeoplasmsAgedChinaFemaleHepatitis BHepatitis B, ChronicHumansIncidenceLiver CirrhosisMaleMiddle AgedPropensity ScoreProportional Hazards ModelsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonists

Identifiers

PMID39134317
PMCPMC11318981

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.