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Temporal trends in cardiovascular burden among patients with prostate cancer receiving androgen deprivation therapy: a population-based cohort study

Chan, Jeffrey Shi Kai, Satti, Danish Iltaf, Lee, Yan Hiu Athena, Hui, Jeremy Man Ho, Dee, Edward Christopher, Ng, Kenrick, Liu, Kang, Tse, Gary, Ng, Chi Fai (2023) Temporal trends in cardiovascular burden among patients with prostate cancer receiving androgen deprivation therapy: a population-based cohort study. British Journal of Cancer, 128 (12). pp. 2253-2260. ISSN 0007-0920. E-ISSN 1532-1827. (doi:10.1038/s41416-023-02271-5) (KAR id:101548)

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Official URL:
https://doi.org/10.1038/s41416-023-02271-5

Abstract

Background: Although androgen deprivation therapy (ADT) is associated with cardiovascular risks, the extent and temporal trends of cardiovascular burden amongst patients with prostate cancer receiving ADT are unclear.

Methods: This retrospective cohort study analyzed adults with PCa receiving ADT between 1993–2021 in Hong Kong, with follow-up until 31/9/2021 for the primary outcome of major adverse cardiovascular events (MACE; composite of cardiovascular mortality, myocardial infarction, stroke, and heart failure), and the secondary outcome of mortality. Patients were stratified into four groups by the year of ADT initiation for comparisons.

Results: Altogether, 13,537 patients were included (mean age 75.5 ± 8.5 years old; mean follow-up 4.7 ± 4.3 years). More recent recipients of ADT had more cardiovascular risk factors and used more cardiovascular or antidiabetic medications. More recent recipients of ADT had higher risk of MACE (most recent (2015–2021) vs least recent (1993–2000) group: hazard ratio 1.33 [1.11, 1.59], P = 0.002; Ptrend < 0.001), but lower risk of mortality (hazard ratio 0.76 [0.70, 0.83], P < 0.001; Ptrend < 0.001). The 5-year risk of MACE and mortality for the most recent group were 22.5% [20.9%, 24.2%] and 52.9% [51.3%, 54.6%], respectively.

Conclusions: Cardiovascular risk factors were increasingly prevalent amongst patients with prostate cancer receiving ADT, with increasing risk of MACE despite decreasing mortality.

Item Type: Article
DOI/Identification number: 10.1038/s41416-023-02271-5
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: University of Kent (https://ror.org/00xkeyj56)
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 08 Jun 2023 09:53 UTC
Last Modified: 09 Jun 2023 08:36 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/101548 (The current URI for this page, for reference purposes)
Chan, Jeffrey Shi Kai: https://orcid.org/0000-0003-0231-2393
Hui, Jeremy Man Ho: https://orcid.org/0000-0003-4512-3138
Ng, Kenrick: https://orcid.org/0000-0001-9132-4075
Tse, Gary: https://orcid.org/0000-0001-5510-1253
Ng, Chi Fai: https://orcid.org/0000-0002-1723-9646
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