(753) Changes in Carotid Intima-Media Thickness and Atherosclerotic Plaques in Patients Undergoing Androgen Deprivation Therapy: A Longitudinal Study

Introduction Androgen deprivation therapy (ADT) is a standard treatment for advanced prostate cancer. While effective in delaying disease progression and alleviating symptoms, ADT is associated with metabolic disturbances and increased cardiovascular risk. However, its short- and mid-term effects on vascular structure remain unclear. Objective To assess longitudinal changes in carotid intima-media thickness (IMT) and in the presence and thickness of atherosclerotic plaques in both carotid arteries of patients undergoing ADT over a 12-month period. Methods We prospectively evaluated men with moderate- to high-risk prostate cancer treated with ADT from January 2022 to January 2024 at our institution. Smokers and those who stopped smoking less than five years earlier, decompensated diabetics, and patients with a history of cardiovascular events were excluded. Ultrasound was used to measure carotid IMT and to evaluate the presence and thickness of atherosclerotic plaques in the right and left carotid arteries. A total of 30 individuals were assessed before initiation of ADT with goserelin acetate 10.8 mg and after 3 months of therapy; among them, 16 patients who remained on ADT were also reassessed after 12 months. Differences between continuous variables were analyzed using the Wilcoxon test in JASP software. Results A significant increase in right carotid artery (RCA) IMT was observed between baseline and 12 months (W = 24, p = 0.043, r = –0.6, large effect) and between 3 and 12 months (W < 0.001, p = 0.002, r = –0.9, very large effect). The mean RCA IMT increased from 0.12 cm (SD = 0.15) to 0.19 cm (SD = 0.26). Similarly, left carotid artery (LCA) IMT significantly increased between baseline and 12 months (W < 0.001, p = 0.002, r = –0.9, very large effect), with the mean rising from 0.085 cm (SD = 0.018) to 0.20 cm (SD = 0.32). At baseline, 50% of patients had atherosclerotic plaques in both arteries; after 3 months, 37% had plaques in both, and after 12 months, 44% had plaques in the LCA and 39% in the RCA. Plaque thickness in the LCA increased significantly between baseline and 12 months (W = 1, p = 0.031, r = –0.9, very large effect), with mean thickness rising from 0.38 cm (SD = 0.17) to 0.74 cm (SD = 0.24). Conclusions ADT was associated with a significant increase in carotid IMT and atherosclerotic plaque thickness after 12 months, suggesting a potential adverse effect on vascular structure and cardiovascular risk. Continuous vascular monitoring is recommended for patients receiving ADT. Disclosure No