Type of androgen deprivation therapy treatment may impact cardiovascular risk
Researchers compared the cardiovascular risks associated with luteinizing hormone-releasing
hormone (LHRH) agonists versus gonadotropin-releasing hormone (GnRH) antagonists in prostate
cancer patients undergoing androgen deprivation therapy (ADT).
Scientists conducted a retrospective analysis using real-world data from more than 45,000 men with
prostate cancer treated with ADT between 1991 and 2020. The data was from a large US patient repository. Using statistical methods, they evaluated primary outcomes.
Results indicated that in the first year after starting hormonal therapy called androgen- deprivation therapy (ADT), the overall risks of major cardiovascular events and mortality were slightly lower compared to subsequent years. Importantly, the study found that the risk of experiencing major cardiovascular events was significantly higher in patients treated with GnRH antagonists than those treated with LHRH agonists. Similarly, the risk of all-cause mortality was also higher with GnRH antagonists.
Factors such as older age, baseline metastasis, receiving treatment in an oncology (versus urology) setting, personal history of major cardiovascular events, tobacco use, White race (compared to Black), and lower BMI were identified as contributing significantly to the risk of major cardiovascular events. These findings highlight the importance of considering cardiovascular risks when selecting ADT therapies for prostate cancer patients, particularly in those with predisposing factors.
J Urol. 2024 Jan;211(1):63-70. doi: 10.1097/JU.0000000000003721. Epub 2023 Oct 5
.PMID: 37796473. DOI: 10.1097/JU.0000000000003721
