Sociodemographic characteristics and clinical data were obtained from both the SEER registry and the Medicare claims data. Sociodemographic characteristics included age, sex, marital status, race and income. Income was derived by linking patients’ zip code to census data. Income was then dichotomized into four quartiles. The comborbid conditions needed for the Charlson comorbidity index were also collected25. Tumor and treatment characteristics included American Joint Committee on Cancer (AJCC) staging, cancer-directed surgery, radiation therapy and chemotherapy. Medication usage was identified using Medicare Part D claims. Beta-blocker usage within 6 months before and in the 12 month period surrounding the diagnosis of PDAC was identified. Beta-blockers considered were acebutolol, atenolol, bisoprolol, carvedilol, labetalol, metoprolol, nadolol, nebivolol, pindolol, propranolol, and sotalol. Beta-1 selective beta-blockers included acebutolol, atenolol, bisoprolol, metoprolol and nebivolol. All other beta-blockers were considered to be non-selective. Patients using a combination of both non-selective and selective beta-blockers were considered as using non-selective beta-blockers. Pre-existing conditions with indications for the use of beta-blockers were also identified. These included hypertension, arrhythmia, acute myocardial infarction, tachycardia, heart failure, angina pectoris, heart valve disease, coronary artery disease, cardiomyopathy and cirrhosis. Patients were considered to have these pre-existing conditions if there were at least two claims among inpatient and outpatient claims more than 6 months, but less than 2 years before PDAC diagnosis26.

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