TY - JOUR
T1 - Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer
T2 - Contemporary Meta-Analyses
AU - Hu, Jiun Ruey
AU - Duncan, Meredith S.
AU - Morgans, Alicia K.
AU - Brown, Jonathan D.
AU - Meijers, Wouter C.
AU - Freiberg, Matthew S.
AU - Salem, Joe Elie
AU - Beckman, Joshua A.
AU - Moslehi, Javid J.
N1 - Publisher Copyright:
© 2020 American Heart Association, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Androgen deprivation therapy is a cornerstone of prostate cancer treatment. Pharmacological androgen deprivation includes gonadotropin-releasing hormone agonism and antagonism, androgen receptor inhibition, and CYP17 (cytochrome P450 17A1) inhibition. Studies in the past decade have raised concerns about the potential for androgen deprivation therapy to increase the risk of adverse cardiovascular events such as myocardial infarction, stroke, and cardiovascular mortality, possibly by exacerbating cardiovascular risk factors. In this review, we summarize existing data on the cardiovascular effects of androgen deprivation therapy. Among the therapies, abiraterone stands out for increasing risk of cardiac events in meta-analyses of both randomized controlled trials and observational studies. We find a divergence between observational studies, which show consistent positive associations between androgen deprivation therapy use and cardiovascular disease, and randomized controlled trials, which do not show these associations reproducibly.
AB - Androgen deprivation therapy is a cornerstone of prostate cancer treatment. Pharmacological androgen deprivation includes gonadotropin-releasing hormone agonism and antagonism, androgen receptor inhibition, and CYP17 (cytochrome P450 17A1) inhibition. Studies in the past decade have raised concerns about the potential for androgen deprivation therapy to increase the risk of adverse cardiovascular events such as myocardial infarction, stroke, and cardiovascular mortality, possibly by exacerbating cardiovascular risk factors. In this review, we summarize existing data on the cardiovascular effects of androgen deprivation therapy. Among the therapies, abiraterone stands out for increasing risk of cardiac events in meta-analyses of both randomized controlled trials and observational studies. We find a divergence between observational studies, which show consistent positive associations between androgen deprivation therapy use and cardiovascular disease, and randomized controlled trials, which do not show these associations reproducibly.
KW - androgen deprivation therapy
KW - cardiooncology
KW - cardiotoxicity
KW - gonadotropin releasing hormone agonists
KW - prostate cancer
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U2 - 10.1161/ATVBAHA.119.313046
DO - 10.1161/ATVBAHA.119.313046
M3 - Review article
C2 - 31969015
AN - SCOPUS:85081157146
SN - 1079-5642
VL - 40
SP - E55-E64
JO - Arteriosclerosis, Thrombosis, and Vascular Biology
JF - Arteriosclerosis, Thrombosis, and Vascular Biology
IS - 3
ER -
