Why the study?
Randomized trials suggesting GnRH antagonists reduce MACE compared with agonists were limited by short follow-up and low event rates.
Does GnRH antagonist therapy reduce major adverse cardiovascular events compared with GnRH agonists in adult men with non-metastatic prostate cancer?
Population
2,538 matched pairs of adult men with non-metastatic prostate cancer initiating ADT within 1 year of diagnosis
Comparison
GnRH antagonist vs GnRH agonist therapy
Design
Retrospective propensity score-matched cohort study
Follow-up
Years 1-10 following ADT initiation
Key result
GnRH antagonist therapy was associated with a lower risk of MACE compared with GnRH agonists in men with non-metastatic prostate cancer (8.0% vs 9.6%; OR 0.80; 95% CI 0.70-0.99; p=0.05).
Authors
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May favor GnRH antagonists to lower MACE in prostate cancer; leaves open confirmation in prospective trials.
Cohort (n=5,076)
Yes
Does GnRH antagonist therapy reduce major adverse cardiovascular events compared with GnRH agonists in adult men with non-metastatic prostate cancer?
Effect estimate: OR 0.80 (95% CI 0.70-0.99)
Absolute Event Rate: 8% vs 9.6%
p-value: p=0.05
In men with non-metastatic prostate cancer, GnRH antagonist therapy is associated with a significantly lower risk of major adverse cardiovascular events compared to GnRH agonists, regardless of baseline cardiovascular disease status.
Ghiblawi et al. (2026) conducted a cohort in Non-metastatic prostate cancer (n=5,076). GnRH antagonist vs. GnRH agonist was evaluated on MACE, defined as myocardial infarction, heart failure exacerbation, stroke or cardiac death (OR 0.80, 95% CI 0.70-0.99, p=0.05). GnRH antagonist therapy was associated with a lower risk of MACE compared with GnRH agonists in men with non-metastatic prostate cancer (8.0% vs 9.6%; OR 0.80; 95% CI 0.70-0.99; p=0.05).