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

• Published in: Journal of cancer research and clinical oncology 2021-04, Vol.147 (4), p.1217-1226
• Main Authors: Kim, Do Kyung, Lee, Hye Sun, Park, Ju-Young, Kim, Jong Won, Ha, Ji Soo, Kim, Jae Heon, Yang, Won Jae, Cho, Kang Su
• Format: Article
• Language: English
• Subjects: Aged; Androgen Antagonists - adverse effects; Cancer Research; Cardiovascular diseases; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - pathology; Cerebrovascular diseases; Cerebrovascular Disorders - chemically induced; Cerebrovascular Disorders - epidemiology; Cerebrovascular Disorders - pathology; Cohort analysis; Cohort Studies; Follow-Up Studies; Hematology; Humans; Incidence; Internal Medicine; Ischemia; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Ischemia - chemically induced; Myocardial Ischemia - epidemiology; Myocardial Ischemia - pathology; Oncology; Original Article – Clinical Oncology; Population studies; Population-based studies; Prognosis; Prostate cancer; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Regression analysis; Republic of Korea - epidemiology; Risk factors; Vascular diseases
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-020-03412-6

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