Androgen deprivation therapy via injection significantly increased the risk of cardiovascular disease (HR 2.94) compared to non-cancerous controls in patients with advanced prostate cancer.
Cohort (n=5,130)
Does androgen deprivation therapy increase the risk of newly onset cardiovascular diseases in patients with advanced prostate cancer compared to matched non-cancerous controls?
Conventional androgen deprivation therapy in advanced prostate cancer is associated with a significantly increased risk of incident cardiovascular disease compared to non-cancerous controls.
Effect estimate: HR 2.94 (95% CI 2.51-3.45)
Absolute Event Rate: 29.2% vs 13.1%
p-value: p=<0.001
PURPOSE: Androgen Deprivation Therapy (ADT) is the mainstay treatment in advanced prostate cancer. We conducted a nationwide population-based study to evaluate the association of ADT and cardiovascular diseases. METHODS: Between 2005 and 2009, patient data from the National Health Insurance database were obtained. We divided newly diagnosed prostate cancer patients into four groups, injection of gonadotropin-releasing hormone agonists and antagonists, oral antiandrogens, orchiectomy and radical prostatectomy only. Another matched non-cancerous control group was also assigned for comparison purposes. Study outcomes were newly onset Cardiovascular Diseases (CVD) and hospital admissions. Multi-variant Cox proportional regression analysis and the Kaplan-Meier method for cumulative incidence were performed. RESULTS: A total of 17,147 newly diagnosed prostate cancer patients were found. After exclusion criteria was considered, the 2,565 remaining patients were then divided into 1,088 subjects in the injection group, 286 in the orchiectomy group, 812 in the oral group and 379 in the radical prostatectomy only group. The mean age of all the patients was 71.2 years. Multi-variant analysis showed a significantly increased risk of CVD in the injection group, orchiectomy group, oral group and radical prostatectomy group (HR = 2.94, 95% CI 2.51 to 3.45, p<0.001, HR = 3.43, 95% CI 2.69 to 4.36, p<0.001, HR = 2.87, 95% CI 2.42 to 3.39, p<0.001, HR = 1.93, 95% CI 1.5 to 2.48, p<0.001, respectively). A time dependent increased risk of CVD was also observed amongst the study groups (p<0.001). CONCLUSIONS: ADT is associated with an increased risk of CVD. For long-term prostate cancer castration therapy, doctors should be aware of this complication and arrange for proper management.
Li et al. (Tue,) conducted a cohort in Advanced prostate cancer (n=5,130). Androgen Deprivation Therapy (Injection of GnRH agonists/antagonists) vs. Matched non-cancerous controls was evaluated on New onset of cardiovascular disease (CVD) censored with patient admissions (HR 2.94, 95% CI 2.51-3.45, p=<0.001). Androgen deprivation therapy via injection significantly increased the risk of cardiovascular disease (HR 2.94) compared to non-cancerous controls in patients with advanced prostate cancer.