Prostate Cancer ADT Has Fewer Cardiovascular Risks Than Expected

The overall risk for major adverse cardiovascular events (MACE) in men with prostate cancer treated with androgen deprivation therapy (ADT) may be lower than previously assumed, with a rate of 1% during the first year following ADT initiation and 3.7% during the first 4 years, according to new real-world data presented at the Society of Urologic Oncology 22nd Annual Meeting.

“This study is what happens in real life,” said lead author Przemyslaw W. Twardowski, MD, from the departments of medical oncology and urologic oncology at Saint John’s Cancer Institute in Santa Monica, California. “The findings are somewhat more optimistic than what might be expected.” 

Men with prostate cancer are known to be at an increased risk for cardiovascular (CV) events. A previous study published in BJU International suggested CV event rates over a 10-year period were 17% to 27% among men treated with ADT. The men were treated between 1995 and 2009.

The new study analyzed the US electronic medical records of 45,059 men with prostate cancer receiving a luteinizing hormone releasing hormone (LHRH) agonist and antagonist injections. The team examined the rate of MACE within 6 months and 1 year of ADT initiation. The database contained 965 documented MACE events.

MACE was defined as myocardial infarction, stroke, and death from any cause. The first MACE experience was used for analysis, and events occurring on the day of ADT initiation were excluded. Rates of MACE were calculated for the entire cohort and also for race. Only men with 6 months and 1 year data points were included in the general analysis.

Within each analysis set, 82% of men were White, 16% were Black, and 2% were Asian. The rate of MACE within 6 months of ADT initiation was 0.5% for the entire cohort, but it varied by race or ethnicity. It was 0.5% for White men, 0.2% for Black men and 0.0% for Asian men.

The rate of MACE within 1 year of ADT initiation was 0.8% for the entire cohort (0.9% for White men, 0.4% for Black men, and 0.3% for Asian men). The risk of MACE was significantly higher in White men compared with Black men for both time periods. “It was against what was expected. It was surprising to me that White men had high rates. I think we need to look at more risk factors in a more granular way,” Dr Twardowski said.

This article originally appeared on Renal and Urology News