Androgen Deprivation in Prostate Cancer Not Tied to CVD Death

But, ADT is associated with reduced risk of prostate cancer-specific mortality, all-cause death

TUESDAY, Dec. 6 (HealthDay News) -- Use of androgen deprivation therapy (ADT) is not associated with cardiovascular death, but is correlated with significantly lower prostate cancer-specific mortality (PCSM) and all-cause mortality, according to a review and meta-analysis published in the Dec. 7 issue of the Journal of the American Medical Association.

Paul L. Nguyen, M.D., from the Brigham and Women's Hospital in Boston, and colleagues reviewed randomized controlled trials from 1966 to 2011 to investigate whether ADT is correlated with cardiovascular mortality, PCSM, and all-cause mortality in men with unfavorable-risk, nonmetastatic prostate cancer. Data from trials which included an intervention group with gonadotropin-releasing hormone agonist-based ADT, a control group with no immediate ADT, complete information on cardiovascular deaths, and a median follow-up of more than one year were analyzed to calculate summary incidence and relative risk.

The investigators found that, based on data from 4,141 patients from eight trials, there was no significant difference in cardiovascular death in patients receiving ADT versus controls (11.0 versus 11.2 percent; P = 0.41). There was no significant association of ADT with excess cardiovascular death in long duration trials of at least three years (11.5 for each; P = 0.34), or in short duration trials of six months or less (10.5 and 10.3 percent, respectively; P = 0.99). Based on overall death data of 4,805 patients from 11 trials, ADT was associated with significantly lower PCSM (relative risk [RR], 0.69) and lower all-cause mortality (RR, 0.86).

"ADT use was not associated with an increased risk of cardiovascular death but was associated with a lower risk of PCSM and all-cause mortality," the authors write.

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