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Published on: March 6, 2018
Prevalence of Preexisting Cardiovascular Diseases in Prostate Cancer Patients and Cardiac Risks of Hormonal Therapy
Abdullah Mousa Alzahrani1, Hend Al Shamsi1, Mohammed Al Momen1
1Department of Urology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Insights
Prostate cancer patients have a 16% prevalence of cardiovascular diseases (CVDs). Androgen deprivation therapy (ADT) increases cardiovascular events (CVEs), with stroke and prior CVD being key risk factors.
Area of Science:
- Oncology
- Cardiology
- Public Health
Background:
- Cardiovascular diseases (CVDs) are a major cause of mortality in prostate cancer patients.
- Patients with pre-existing CVDs face elevated risks.
- Limited data exists on CVD prevalence in Saudi Arabian prostate cancer patients.
Purpose of the Study:
- To determine the prevalence of pre-existing CVDs in prostate cancer patients in Saudi Arabia.
- To identify risk factors for new cardiovascular events (CVEs) in patients undergoing androgen deprivation therapy (ADT).
Main Methods:
- Retrospective study of prostate cancer patients diagnosed between October 2008 and January 2019.
- Analysis of pre-existing CVD prevalence and incidence of new CVEs post-ADT initiation.
- Risk factor identification using univariate and multivariate regression analyses.
Main Results:
- 16% of prostate cancer patients had pre-existing CVDs.
- 6% of patients on ADT experienced CVEs after a median follow-up of 39 months.
- History of stroke and CVD (with or without stents) were significant risk factors for new CVEs post-ADT.
Conclusions:
- Approximately one-fifth of prostate cancer patients present with pre-existing CVDs.
- Luteinizing hormone-releasing hormone agonists (a form of ADT) may increase the risk of new CVEs.
- Identifying and managing CVD risk factors is crucial for prostate cancer patients undergoing ADT.
Background:
Cardiovascular diseases (CVDs) are a prominent cause of mortality in prostate cancer patients. However, it has been reported that patients with preexisting CVDs are at greater risk. Literature on the magnitude of this problem in Saudi Arabia is lacking.
Objectives:
To measure the prevalence of prostate cancer patients with preexisting CVDs in our population and to elucidate the possible risk factors of new cardiovascular events (CVEs) in patients who received androgen deprivation therapy (ADT).
Materials And Methods:
This retrospective study included all patients newly diagnosed with prostate cancer at a tertiary hospital in the Eastern Province of Saudi Arabia from October 2008 to January 2019. The prevalence of preexisting cardiovascular diseases in these patients were determined. In addition, the incidence of new CVEs after initiating ADT was determined along with the risk factors for the same.
Results:
The prevalence of preexisting CVD in our cohort was 16%. About 6% of the patients who received ADT had CVEs after a median follow-up of 39 months (IQR: 11-49 months). In the univariate analysis, hyperlipidemia (P = 0.002), stroke (P = 0.001), peripheral vascular disease (P = <0.001), cardiac patients with stents (P = <0.001), and cardiac patients without stent (P = <0.001) were significant risk factors of new CVEs after initiating ADT. However, in the multivariate regression analysis, only history of stroke and CVD (with or without stent) were found to be significant risk factors of new CVEs after initiating ADT (P = 0.01).
Conclusion:
About one-fifth of the prostate cancer patients had preexisting CVDs. This study also found that luteinizing hormone-releasing hormone agonist could be a risk factor for new CVEs.
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