Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer: Contemporary Meta-Analyses

Jiun Ruey Hu; Meredith S. Duncan; Alicia K. Morgans; Jonathan D. Brown; Wouter C. Meijers; Matthew S. Freiberg; Joe Elie Salem; Joshua A. Beckman; Javid J. Moslehi

doi:10.1161/ATVBAHA.119.313046

Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer: Contemporary Meta-Analyses

Jiun Ruey Hu
, Meredith S. Duncan
, Alicia K. Morgans
, Jonathan D. Brown
, Wouter C. Meijers
, Matthew S. Freiberg
, Joe Elie Salem
, Joshua A. Beckman
, Javid J. Moslehi

Research output: Contribution to journal › Review article › peer-review

155 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	E55-E64
Journal	Arteriosclerosis, Thrombosis, and Vascular Biology
Volume	40
Issue number	3
DOIs	https://doi.org/10.1161/ATVBAHA.119.313046
State	Published - Mar 1 2020

Bibliographical note

Publisher Copyright:
© 2020 American Heart Association, Inc.

Funding

This work was supported by National Institute of Health grants R56HL141466 and R01HL141466. W.C. Meijers was supported by funding from the Niels Stensen Fellowship and the Netherlands Heart Institute.

Funders	Funder number
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)	R56HL141466
National Heart, Lung, and Blood Institute (NHLBI)
ICIN-Netherlands Heart Institute

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

androgen deprivation therapy
cardiooncology
cardiotoxicity
gonadotropin releasing hormone agonists
prostate cancer

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1161/ATVBAHA.119.313046

Cite this

@article{eeabbd270a6742cfb9d22d03ce6ba3b3,

title = "Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer: Contemporary Meta-Analyses",

abstract = "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.",

keywords = "androgen deprivation therapy, cardiooncology, cardiotoxicity, gonadotropin releasing hormone agonists, prostate cancer",

author = "Hu, \{Jiun Ruey\} and Duncan, \{Meredith S.\} and Morgans, \{Alicia K.\} and Brown, \{Jonathan D.\} and Meijers, \{Wouter C.\} and Freiberg, \{Matthew S.\} and Salem, \{Joe Elie\} and Beckman, \{Joshua A.\} and Moslehi, \{Javid J.\}",

note = "Publisher Copyright: {\textcopyright} 2020 American Heart Association, Inc.",

year = "2020",

month = mar,

day = "1",

doi = "10.1161/ATVBAHA.119.313046",

language = "English",

volume = "40",

pages = "E55--E64",

number = "3",

}

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.

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

UR - https://www.scopus.com/pages/publications/85081157146

UR - https://www.scopus.com/pages/publications/85081157146#tab=citedBy

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 -

Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer: Contemporary Meta-Analyses

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this