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Does androgen-deprivation therapy increase the risk of ischemic cardiovascular and cerebrovascular diseases in patients with prostate cancer? A nationwide population-based cohort study

Authors
 Do Kyung Kim  ;  Hye Sun Lee  ;  Ju-Young Park  ;  Jong Won Kim  ;  Ji Soo Ha  ;  Jae Heon Kim  ;  Won Jae Yang  ;  Kang Su Cho 
Citation
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, Vol.147(4) : 1217-1226, 2021-04 
Journal Title
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 
ISSN
 0171-5216 
Issue Date
2021-04
MeSH
Aged ; Androgen Antagonists / adverse effects* ; Cardiovascular Diseases / chemically induced ; Cardiovascular Diseases / epidemiology* ; Cardiovascular Diseases / pathology ; Cerebrovascular Disorders / chemically induced ; Cerebrovascular Disorders / epidemiology* ; Cerebrovascular Disorders / pathology ; Cohort Studies ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Ischemia / chemically induced ; Myocardial Ischemia / epidemiology* ; Myocardial Ischemia / pathology ; Prognosis ; Prostatic Neoplasms / drug therapy* ; Prostatic Neoplasms / pathology ; Republic of Korea / epidemiology
Keywords
Androgen-deprivation therapy ; Cardiovascular disease ; Cerebrovascular disease ; Prostate cancer
Abstract
Purpose: We investigated whether ADT use was associated with the risk of ischemic cardiovascular diseases (CVD) and cerebrovascular diseases (CrVD) in a nationwide population-based cohort. Methods: Claims data of the Health Insurance and Review Assessment system in South Korea were used. In total, 195,308 men with newly diagnosed prostate cancer between January 1, 2008 and December 31, 2017 were identified. After applying the exclusion criteria, 131,189 men were enrolled. The study cohort was divided into ADT and non-ADT groups. Study outcomes were newly developed CVD, cardiovascular intervention (CVI), and CrVD. To control for potential confounders, various cardiovascular risk factors were balanced between groups. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events. Results: Univariable analysis revealed that ADT was significantly associated with an increased risk of CVD and CrVD. Multivariable analysis did not reveal this association. In the propensity score matched cohort (n = 61,722), multivariable analysis demonstrated that ADT independently reduced the risk of CVD (HR 0.890; 95% CI 0.846-0.936; p < 0.0001), CVI (HR 0.873; 95% CI 0.770-0.991; p = 0.0352), and CrVD (HR 0.869; 95% CI 0.824-0.917; p < 0.0001). CVD risk was significantly decreased in patients using ADT for over 2 years. CVI and CrVD risks were significantly lower in men using ADT for over 3 years. Conclusion: This study demonstrated that ADT may reduce the risk of CVD, CVI, and CrVD, and ADT duration is associated with this risk reduction.
Full Text
https://link.springer.com/article/10.1007%2Fs00432-020-03412-6
DOI
10.1007/s00432-020-03412-6
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Ha, Jee Soo(하지수) ORCID logo https://orcid.org/0000-0002-3923-4619
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182381
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