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Cardiovascular disease risk and androgen deprivation therapy in patients with localised prostate cancer: a prospective cohort study

British journal of cancer, 2017-10, Vol.117 (8), p.1233-1240 [Peer Reviewed Journal]

Copyright Nature Publishing Group Oct 10, 2017 ;Copyright © 2017 Cancer Research UK 2017 Cancer Research UK ;ISSN: 0007-0920 ;EISSN: 1532-1827 ;DOI: 10.1038/bjc.2017.280 ;PMID: 29017178

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Title:
Cardiovascular disease risk and androgen deprivation therapy in patients with localised prostate cancer: a prospective cohort study
Author: Haque, Reina ; UlcickasYood, Marianne ; Xu, Xiaoqing ; Cassidy-Bushrow, Andrea E ; Tsai, Huei-Ting ; Keating, Nancy L ; Van Den Eeden, Stephen K ; Potosky, Arnold L
Subjects: Aged ; Androgen Antagonists - therapeutic use ; Anilides - therapeutic use ; Antineoplastic Agents, Hormonal - therapeutic use ; Arrhythmia ; Arrhythmias, Cardiac - epidemiology ; California - epidemiology ; Cancer ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cohort Studies ; Conduction ; Drugs ; Epidemiology ; Flutamide - therapeutic use ; Gonadotropin-Releasing Hormone - agonists ; Goserelin - therapeutic use ; Health risk assessment ; Health risks ; Heart diseases ; Heart failure ; Heart Failure - epidemiology ; Humans ; Imidazolidines - therapeutic use ; Leuprolide - therapeutic use ; Male ; Men ; Middle Aged ; Minority & ethnic groups ; Multivariate Analysis ; Neoplasm Grading ; Nitriles - therapeutic use ; Proportional Hazards Models ; Prospective Studies ; Prostate ; Prostate cancer ; Prostatic Neoplasms - drug therapy ; Prostatic Neoplasms - epidemiology ; Prostatic Neoplasms - pathology ; Risk Factors ; Surveillance ; Tosyl Compounds - therapeutic use ; Tumors
Is Part Of: British journal of cancer, 2017-10, Vol.117 (8), p.1233-1240
Description: As androgen deprivation therapy (ADT) is increasingly being used in men with localised prostate cancer, our goal was to examine the association between ADT and the risk of cardiovascular disease (CVD). We conducted a prospective cohort study using records of a large health-care system in California. The study included men with newly diagnosed localised prostate cancer (1998-2008) who initially underwent active surveillance (N=7637) and were followed through 2010. We examined 10 individual CVD outcomes. Cox proportional hazard models incorporated time-varying treatment variables and controlled for race/ethnicity, age, and tumour characteristics, recurrence risk, CVD medication use, and CVD risk factors. Of the 7637 subjects, nearly 30% were exposed to ADT. In the multivariable analyses, ADT was associated with an increased risk of heart failure (adjusted HR=1.81, 95% CI 1.40-2.32) in men without preexisting CVD. Elevated risks of arrhythmia (adjusted HR=1.44, 95% CI 1.02-2.01), and conduction disorder (adjusted HR=3.11, 95% CI 1.22, 7.91) were only observed among patients with preexisting CVD. In men with clinically localised prostate cancer who were initially under active surveillance, ADT was associated with a greater risk of heart failure in men without any preexisting CVD. We also found an increased risk of arrhythmia and conduction disorder in men with preexisting CVD. This study provides the basis for identifying high-risk men treated with ADT who might benefit from regular cardiac monitoring and lifestyle modification recommendations.
Publisher: England: Nature Publishing Group
Language: English
Identifier: ISSN: 0007-0920
EISSN: 1532-1827
DOI: 10.1038/bjc.2017.280
PMID: 29017178
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
ProQuest Central

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Cardiovascular disease risk and androgen deprivation therapy in patients with localised prostate cancer: a prospective cohort study

Copyright Nature Publishing Group Oct 10, 2017 ;Copyright © 2017 Cancer Research UK 2017 Cancer Research UK ;ISSN: 0007-0920 ;EISSN: 1532-1827 ;DOI: 10.1038/bjc.2017.280 ;PMID: 29017178

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