Key result
Androgen-deprivation therapy was associated with a significantly increased risk of acute myocardial infarction compared to no ADT in patients with prostate cancer (P=0.004).
Why the study?
Does androgen-deprivation therapy increase the risk of acute myocardial infarction in Chinese patients with prostate cancer?
Cohort (n=452)
No
Does androgen-deprivation therapy increase the risk of acute myocardial infarction in Chinese patients with prostate cancer?
p-value: p=0.004
Androgen-deprivation therapy for prostate cancer is associated with an increased risk of acute myocardial infarction in a Chinese population, highlighting the need for cardiovascular risk assessment in these patients.
Supports CV monitoring during ADT in Chinese prostate cancer patients; extends prior associations but leaves causal inference open.
OBJECTIVE: To investigate the risk of acute myocardial infarction (AMI) after androgen-deprivation therapy (ADT) for prostate cancer in a Chinese population. PATIENTS AND METHODS: All Chinese patients with prostate cancer who were treated primarily with radical prostatectomy or radiotherapy, with or without further ADT at our hospital from the year 2000 to 2009 were retrospectively reviewed. We compared the risk of AMI in the patients who were given further ADT (ADT group) with those who were not given any ADT (non-ADT group). Potential risk factors of AMI including age, diabetes mellitus, hypertension, hyperlipidaemia, history of stroke, ischaemic heart disease, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and duration of ADT were reviewed. The risk of AMI after ADT was first analysed using the Kaplan-Meier method, followed by Cox regression analyses including the potential risk factors mentioned. RESULTS: In all, 452 patients were included, with 200 patients in the non-ADT group and 252 patients in the ADT group. The mean (sd) age was 68.2 (5.9) years in the non-ADT group and 69.5 (6.5) years in the ADT group, and the difference was statistically significant (P = 0.031). There were no significant differences in their pre-existing medical conditions or ECOG PS. The ADT group was associated with an increased risk of AMI when compared with the non-ADT group (P = 0.004) upon Kaplan-Meier analysis. Upon multivariate Cox regression analysis, hyperlipidaemia, poor ECOG PS and the use of ADT were the only three significant factors that were associated with increased risk of developing new AMI. CONCLUSIONS: There was increased risk of AMI after ADT for prostate cancer in a Chinese population. Hyperlipidaemia and poor ECOG PS were also significant risk factors for developing AMI. The risk of AMI should be considered when deciding on ADT, especially in patients with history of hyperlipidaemia and relatively poor ECOG PS.
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Teoh et al. (2014) conducted a cohort in Prostate cancer (n=452). Androgen-deprivation therapy (ADT) vs. No ADT was evaluated on Acute myocardial infarction (AMI) (p=0.004). Androgen-deprivation therapy was associated with a significantly increased risk of acute myocardial infarction compared to no ADT in patients with prostate cancer (P=0.004).
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