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March 4, 2026Journal of Clinical Oncology0 citations

Prevalence of Major Adverse Cardiac Events in Men with Prostate Cancer Receiving ADT

Prevalence of major adverse cardiac events in men with prostate cancer receiving androgen deprivation therapy in real-world clinical practice.

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Why the study?

ADT is associated with increased MACE risk in prostate cancer, but the prevalence of MACE in real-world clinical practice is unknown.

Do GnRH antagonists reduce the rate of major adverse cardiac events compared to GnRH agonists in men with prostate cancer receiving androgen deprivation therapy?

Population

17,336 men with prostate cancer newly initiating ADT in the United States

Comparison

GnRH antagonists vs GnRH agonists, and pre- vs post-relugolix approval

Design

Observational database study

Follow-up

126 days for antagonists vs 189 days for agonists

Key result

GnRH antagonist users had 36-37% lower 2- and 3-point MACE prevalence (2.3 vs 3.6 and 2.6 vs 4.1 per 100 person-years) than agonist users in real-world ADT.

Authors

AHAndrew W. HahnCLCassandra LickertMCMichele Cole

Discussion

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Member takes

Overview

May support GnRH antagonists over agonists for ADT in high-CV-risk prostate cancer; extends RCT data but leaves open need for confirmatory trials.

Key Points

  • This study aims to evaluate the prevalence of major adverse cardiac events (MACE) in men with prostate cancer undergoing androgen deprivation therapy (ADT) in real-world settings.
  • Identified men with prostate cancer who started ADT from January 2018 to May 2024 based on insurance claims data.
  • Followed patients for 12 months pre-index and 60+ days post-index of ADT initiation.
  • Assessed demographics, baseline characteristics, and MACE rates, comparing those on GnRH agonists and antagonists.
  • Out of 17,336 men, 90.4% received a GnRH agonist and 9.6% a GnRH antagonist.
  • Prevalence rates for 2-point and 3-point MACE were 3.5 and 4.0 per 100 person-years respectively.
  • Men on GnRH antagonists had lower MACE prevalence (2.3 vs 3.6 for 2-point MACE and 2.6 vs 4.1 for 3-point MACE) compared to agonists.

Structured PICO

Do GnRH antagonists reduce the rate of major adverse cardiac events compared to GnRH agonists in men with prostate cancer receiving androgen deprivation therapy?

P
Population
17,336 men with prostate cancer who newly initiated androgen deprivation therapy (ADT) between January 2018 and May 2024 in the United States, median age 69 years.
I
Intervention
Gonadotropin-releasing hormone (GnRH) antagonists (e.g., degarelix, relugolix)
C
Comparator
Gonadotropin-releasing hormone (GnRH) agonists (e.g., leuprolide)
O
Outcome
Rate of 2- and 3-point MACE (non-fatal myocardial infarction or stroke [2- and 3-point], or all-cause death [3-point])composite

In real-world practice, men with prostate cancer receiving GnRH antagonists had numerically lower rates of major adverse cardiac events compared to those receiving GnRH agonists.

Limitations

  • Differences in baseline characteristics remain between groups

Cite This Study

Hahn et al. (2026) studied this question. GnRH antagonist users had 36-37% lower 2- and 3-point MACE prevalence (2.3 vs 3.6 and 2.6 vs 4.1 per 100 person-years) than agonist users in real-world ADT.

synapsesocial.com/papers/69a7cd1dd48f933b5eed929fhttps://doi.org/10.1200/jco.2026.44.7_suppl.107
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A retrospective analysis of cardiovascular outcomes in patients with prostate cancer treated with upfront gonadotropin-releasing agonist versus antagonists utilizing real-world data.2026
  2. 2Association of cardiovascular outcomes with GnRH agonist and antagonist therapy in non-metastatic prostate cancer.2026 · 1 citations
  3. 3The Risk of Cardiovascular Disease in Prostate Cancer Patients Receiving Androgen Deprivation Therapies2019 · 42 citations
  4. 4Coronary Plaque Progression After Androgen Deprivation Therapy in Men With Prostate Cancer2026 · 11 citations
  5. 5Cardiovascular Safety of Degarelix Versus Leuprolide for Advanced Prostate Cancer2020 · 50 citations