J Urol: Comparison of cardiotoxicity between surgical castration and medical castration in prostate cancer patients

Androgen deprivation therapy (ADT) includes bilateral orchiectomy and long-acting gonadotropin releasing hormone (GnRH) agonist/antagonist
.

There is still controversy regarding the cardiovascular outcomes related to ADT

Recently, a researcher published an article in the journal J Urol comparing the risk of major adverse cardiovascular and cerebrovascular events (MACCEs) in prostate cancer patients undergoing surgical castration or GnRH therapy
.

Compare the risk of major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with prostate cancer when undergoing surgical castration or GnRH therapy.
) Risk profile

The researchers used data from the Cancer Registry (TCR) and the Health Insurance Research Database (NHIRD) to identify 8,413 patients who received GnRH therapy and 694 patients who received surgical castration from 2008 to 2017
.

The criteria for exclusion are the incomplete medical records of the cancer stage and the age less than 18 years old

The main result is the composite endpoint of MACCEs, which includes acute myocardial infarction (AMI) after surgical castration or medical castration, congestive heart failure (CHF) requiring hospitalization, and ischemic stroke (including transient ischemic attack [ TIA]) The main result is the composite endpoint of MACCEs, which includes acute myocardial infarction (AMI) after surgical castration or medical castration, congestive heart failure (CHF) requiring hospitalization, and ischemic stroke (including transient brain deficiency) Blood attack [TIA])

The results of the study found that among patients receiving GnRH therapy or surgical castration, the crude incidence of 3-year mortality and MACCEs were 19.
90% vs 26.
51% and 8.
23% vs 8.
65%, respectively
.

After adjusting for age, cancer stage, and comorbidities, it was found that there was no significant difference in MACCEs between the groups, but compared with patients receiving GnRH therapy, the incidence of acute myocardial infarction (AMI) was slightly increased in patients who received surgical castration

Three-year MACCEs risk subgroup analysis after surgical castration or medical castration

Three-year MACCEs risk subgroup analysis after surgical castration or medical castration

In summary, prostate cancer patients have an increased risk of AMI, especially those who have undergone surgical castration, rather than those who have received GnRH therapy
.

The study also emphasized that attention should be paid to the impact of surgical castration and GnRH therapy on cardiac safety

Patients with prostate cancer have an increased risk of AMI, especially those who have undergone surgical castration, rather than those who have received GnRH therapy

Original source:

Wei-Chih Kan, Kun-Lin Hsieh, Yi-Chen Chen et al.

 

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