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Risk of cardiovascular intervention after androgen deprivation therapy in prostate cancer patients with a prior history of ischemic cardiovascular and cerebrovascular disease: A nationwide population-based cohort study

Authors
 Do Kyung Kim  ;  Hye Sun Lee  ;  Ju-Young Park  ;  Jong Won Kim  ;  Yoon Soo Hah  ;  Jee Soo Ha  ;  Jae Heon Kim  ;  Kang Su Cho 
Citation
 UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, Vol.40(1) : 6.e11-6.e19, 2022-01 
Journal Title
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
ISSN
 1078-1439 
Issue Date
2022-01
MeSH
Aged ; Aged, 80 and over ; Androgen Antagonists / therapeutic use* ; Cardiovascular Diseases / complications* ; Cardiovascular Diseases / surgery* ; Cerebrovascular Disorders / complications* ; Cerebrovascular Disorders / surgery* ; Cohort Studies ; Humans ; Male ; Middle Aged ; Myocardial Ischemia / complications* ; Myocardial Ischemia / surgery* ; Prostatic Neoplasms / complications* ; Prostatic Neoplasms / drug therapy* ; Risk Assessment
Keywords
Androgen deprivation therapy ; Cardiovascular disease ; Cerebrovascular disease ; Prostate cancer
Abstract
Background: Androgen deprivation therapy for prostate cancer is known to increase the risk of cardiovascular disease, but there is controversy regarding the cardiovascular risk in patients with preexisting cardiovascular disease. This study assessed the risk of cardiovascular intervention after androgen deprivation therapy in patients with a history of cardiovascular disease, cerebrovascular disease, and cardiovascular intervention.

Materials and methods: Between 2008 and 2017, 195,308 men with newly diagnosed prostate cancer were identified from the nationwide claims database in South Korea. Among them, 49,090 men with a history of ischemic cardiovascular and cerebrovascular diseases were analyzed. The patients were divided into the androgen deprivation therapy (n = 14,092) and non-androgen deprivation therapy (n = 34,988) groups. The primary outcome was cardiovascular interventions (percutaneous transluminal angioplasty and coronary bypass surgery). Cox proportional hazard regression models were used to estimate the adjusted hazard ratios and 95% confidence intervals of the events.

Results: After balancing the covariates with 1:1 exact matching, the two groups had 10,514 subjects each. Multivariable analysis demonstrated that androgen deprivation therapy was not significantly associated with an increased risk of cardiovascular interventions (hazard ratio, 1.060; 95% confidence interval, 0.923-1.217; P = 0.4104), regardless of the duration of therapy. A history of cardiovascular intervention, diabetes mellitus, antithrombotic medication use, and cardiovascular events significantly increased the risk of cardiovascular intervention.

Conclusions: Androgen deprivation therapy was not associated with cardiovascular intervention in patients with a previous history of cardiovascular disease, regardless of the duration of therapy. Therefore, the cardiovascular risk of androgen deprivation therapy should be reassessed in this population.
Full Text
https://www.sciencedirect.com/science/article/pii/S1078143921003021
DOI
10.1016/j.urolonc.2021.07.002
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 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/22282913/187924
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