Does ADT increase the risk of cerebral infarction?

Cerebral infarction occurs when an artery that supplies blood to the brain is blocked or narrowed, depriving the brain of oxygen that it needs to stay alive. Clinically, this is known as an ischemic stroke. A possible connection between ADT and ischemic stroke has been suggested, given the association of ADT with other cardiovascular disease. However, a new large-scale study out of Korea failed to find a direct link between ADT and cerebral infarction. The data are from a retrospective study of 36,146 prostate cancer patients, 24,069 of whom were on ADT.

When the sample was analyzed as a whole, the researchers found a higher incidence of ischemic stroke in men who had been treated with ADT, compared to those who had not been treated with ADT.

However, the researchers noted several potentially confounding factors. In particular, ADT is associated with increased risk of diabetes, hypertension, and peripheral vascular disease. Indeed, when these potentially confounding factors were controlled for in the analyses, the researchers no longer found an increased risk of cerebral infarction associated with ADT. The amount of time men were on ADT was similarly not associated with increased risk of an ischemic stroke.

The good news is that ADT does not directly increase the risk of a stroke. However, the real take-away from this study is the need to properly manage ADT side effects, like diabetes and cardiovascular disease. Maintaining cardiovascular health while on ADT may be good for one’s health overall.

To read the full article, please see:

Tae, B. S., Jeon, B. J., Choi, H., Bae, J. H., & Park, J. Y. (2019). Is androgen deprivation therapy associated with cerebral infarction in patients with prostate cancer? A Korean nationwide population-based propensity score matching study. Cancer Medicine (Epub ahead of print). DOI: 10.1002/cam4.2325