PulseExploreJournal ClubDebatesTrendingResearchersJournals
Instagram
HomeExploreJournal ClubTrending
Synapse
⌘+K
Synapse
October 25, 2019EpidemiologyOpen Access

The Risk of Cardiovascular Disease in Prostate Cancer Patients Receiving Androgen Deprivation Therapies

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does androgen deprivation therapy increase the risk of cardiovascular events in men newly diagnosed with prostate cancer?

Population

20,216 men newly diagnosed with prostate cancer between 2009 and 2015 in Scotland.

Comparison

Androgen deprivation therapy including GnRH… vs Untreated patients.

Design

Cohort

Follow-up

73,570 person-years total

Key result

Androgen deprivation therapy was associated with a 25% increase in cardiovascular events (HR 1.25) compared with untreated patients, reflecting increases with GnRH agonists and degarelix.

Authors

CCChris R. CardwellJOJoe M. O’SullivanSJSuneil Jain

Discussion

Loading...

Member takes

Overview

May warrant CV surveillance with ADT in prostate cancer; extends observational data but leaves causality open for RCTs.

Study Design

Type

Cohort (n=20,216)

Multicenter

Yes

Structured PICO

Does androgen deprivation therapy increase the risk of cardiovascular events in men newly diagnosed with prostate cancer?

P
Population
20,216 men newly diagnosed with prostate cancer between 2009 and 2015 in Scotland.
I
Intervention
Androgen deprivation therapy (ADT) including GnRH agonists (goserelin, leuprorelin, triptorelin, histrelin), the GnRH antagonist degarelix, bicalutamide monotherapy, and other antiandrogens, analyzed as a time-varying exposure.
C
Comparator
Untreated patients (receiving active surveillance or watchful waiting).
O
Outcome
Cardiovascular event consisting of either death from cardiovascular disease or hospitalisation for cardiovascular disease.composite

Main Result

Effect estimate: HR 1.25 (95% CI 1.16-1.35)

In a real-world cohort of prostate cancer patients, androgen deprivation therapy with GnRH agonists or degarelix was associated with a significantly increased risk of cardiovascular events, whereas bicalutamide monotherapy was not.

Limitations

  • Possibility of residual confounding by incompletely recorded (stage, Gleason score) or unavailable variables (obesity, smoking, alcohol intake)
  • ADT use was determined from dispensing records and medication adherence cannot be confirmed
  • Patients receiving ADT may have increased exposure to health care professionals increasing the likelihood of cardiovascular disease being identified
  • Possibility of residual confounding by incompletely recorded variables (stage, Gleason score) or unavailable variables (lifestyle cardiovascular disease risk factors including obesity, smoking or alcohol intake).
  • Medication adherence cannot be confirmed from dispensing records.
  • Patients receiving ADT may have increased exposure to health care professionals increasing the likelihood of cardiovascular disease being identified.

Cite This Study

Cardwell et al. (2019) conducted a cohort in Prostate cancer (n=20,216). Androgen deprivation therapy (ADT) vs. Untreated patients (active surveillance or watchful waiting) was evaluated on Cardiovascular event (death from cardiovascular disease or hospitalisation for cardiovascular disease) (HR 1.25, 95% CI 1.16-1.35). Androgen deprivation therapy was associated with a 25% increase in cardiovascular events (HR 1.25) compared with untreated patients, reflecting increases with GnRH agonists and degarelix.

synapsesocial.com/papers/6a09069262c780efd627fb7dhttps://doi.org/10.1097/ede.0000000000001132
View Full Paper
Ask AI
Bookmark
Share