New U.S./Northern Ireland study using data from Scotland, below [1].
"The cohort contained 20,216 prostate cancer patients, followed for 73,570 person-years, during which there were 3,853 cardiovascular events. ADT was associated with a 30% increase in cardiovascular events ..."
"This reflected increases in cardiovascular events associated with GnRH agonists (adjusted HR=1.3 ...), degarelix (adjusted HR=1.5 ...), but not bicalutamide monotherapy (adjusted HR=1.0 ...)."
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/316...
Epidemiology. 2019 Oct 21. doi: 10.1097/EDE.0000000000001132. [Epub ahead of print]
The risk of cardiovascular disease in prostate cancer patients receiving androgen deprivation therapies.
Cardwell CR1, O'Sullivan JM2,3, Jain S2,3, Harbinson MT4, Cook MB5, Hicks BM1, Mc Menamin ÚC1.
Author information
1
Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.
2
Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland, UK.
3
Radiotherapy Department, Cancer Centre, Belfast City Hospital, Belfast, Northern Ireland, UK.
4
Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland, UK.
5
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
Abstract
BACKGROUND:
Androgen deprivation therapy (ADT), with a proven role in prostate cancer management, has been associated with various cardiovascular diseases. However, few studies have investigated these associations by type of ADT, particularly for newer ADTs such as the gonadotropin-releasing hormone (GnRH) antagonist degarelix. We investigated the risk of cardiovascular disease by type of ADT in a real-world setting.
METHODS:
We identified men newly diagnosed with prostate cancer, from 2009 to 2015, from the Scottish Cancer Registry and ADTs from the nationwide Prescribing Information System. Cardiovascular events were based upon hospitalization (from hospital records) or death from cardiovascular disease (from death records). We used Cox regression to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular events with time-varying ADT exposure, comparing ADT users with untreated patients, after adjusting for potential confounders, including prior cardiovascular disease.
RESULTS:
The cohort contained 20,216 prostate cancer patients, followed for 73,570 person-years, during which there were 3,853 cardiovascular events. ADT was associated with a 30% increase in cardiovascular events (adjusted HR=1.3 95% CI 1.2, 1.4). This reflected increases in cardiovascular events associated with GnRH agonists (adjusted HR=1.3 95% CI 1.2, 1.4), degarelix (adjusted HR=1.5 95% CI 1.2, 1.9), but not bicalutamide monotherapy (adjusted HR=1.0 95% CI 0.82, 1.3).
CONCLUSIONS:
There were increased risks of cardiovascular disease with use of GnRH agonists and degarelix, but not with bicalutamide monotherapy. This is the first study to observe increased cardiovascular risks with degarelix, but the cause of this association is unclear and merits further investigation.
PMID: 31651660 DOI: 10.1097/EDE.0000000000001132