Risk of CVD Lower Than Expected from ADT for Prostate Cancer

By Lou Portero - Last Updated: March 8, 2022

Patients living with prostate cancer may not be in as much danger as assumed. It is common knowledge that prostate cancer patients are at an increased risk for cardiovascular events. A previous study, published in the British Journal of Urology (BJU) International, suggested cardiovascular event rates over 10 years were between 17% and 27% among patients treated with Androgen Deprivation Therapy (ADT).

Recent real-world data presented at the Society of Urology and Oncology at the 22nd Annual Meeting revealed that the risk for major adverse cardiovascular events (MACE) in patients with cancer treated with ADT may be much lower than projected. The rate of occurrence was 1% during the first year following initiation and 3.7% during the first four years.

Major adverse cardiovascular events (MACE) can be described as myocardial infarction, stroke, and death from any cause. The new research scrutinized the US electronic medical records of 45,059 men with prostate cancer receiving luteinizing hormone-releasing hormone (LHRH) agonist and antagonist injections. The team studied the rate of MACE within 6 months and 1 year of ADT treatment. The database contained 965 documented MACE events.

82% of patients were White, 16% were Black, and 2% were Asian within each analysis set. The rate of MACE in the 6 months of ADT initiation was 0.5% for the entire group, but it varied by race or ethnicity. It was 0.5% for White patients, 0.2%for Black patients, and 0.0 for Asian patients. The rate of MACE within 1 year of ADT initiation was 0.8% for the entire cohort(0.9% for White patients,0.4% for Black patients, and 0.3% for Asian patients).

The study identified that the risk of MACE was higher in White patients compared to Black patients for both durations. It was against what was expected. Dr. Twardowski revealed that it was surprising to him that White patients had high rates, he then expressed his thoughts on the need to look closely at more risk factors.

It is still yet to be known why race is a predictor of MACE risk. Christopher Saigal, Master of Public Health and vice-chair at the David Geffen School of Medicine at the University of California in Los Angeles, said the study still needs to be approved because it is uncertain how precisely this individual health system captured all of the MACE events in this patient population.

However, Eiman Jahangir, MD, Associate professor of Medicine at Vanderbilt University in Tennessee, believes the findings are clinically relevant because they add to the body of knowledge about how the shift toward LHRH antagonists may be affecting MACE risk factors.

Source – https://www.renalandurologynews.com/home/news/urology/prostate-cancer/adt-for-metastatic-prostate-cancer-causes-fewer-cardiovascular-problems-than-thought/ (Some links may require subscription)

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