Association of Androgen Deprivation Therapy with Excess Cardiac-Specific Mortality in Men with Prostate Cancer. By Ziehr. 2014
Key sentence from the paper: “For… patients with low-risk disease, ADT has no prostate cancer benefit, and could induce cardiac harm.”
For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25124891
Commentary: It is well known that patients with cardiovascular disease are at increased risk of cardiac death when they are on ADT, but, are all cardiovascular risks the same? This study shows that having diabetes, hypertension, and/or high cholesterol, does not significantly increase the risk of death in the following year for patients on ADT. Two preexisting conditions though are of particular concern: a history of congestive heart failure and having a previous myocardial infarction (heart attack). To quote from the authors: “in men with congestive failure or prior myocardial infarction, administering ADT to 20 men in this potentially vulnerable subgroup could result in one cardiac death” within the next 5 years.
This paper is important in helping physicians decide which patients should or should not be started on ADT.
Ziehr DR, Chen MH, Zhang D, Braccioforte MH, Moran BJ, Mahal BA, Hyatt AS, Basaria SS, Beard CJ, Beckman JA, Choueiri TK, D'Amico AV, Hoffman KE, Hu JC, Martin NE, Sweeney CJ, Trinh QD, Nguyen PL. 2014. Association of Androgen Deprivation Therapy with Excess Cardiac-Specific Mortality in Men with Prostate Cancer. BJU International. 15 August 2014 [Epub ahead of print]