ecancermedicalscience

Research

Cardiac risk factors and events in patients with prostate cancer commencing androgen deprivation therapy: analysis from a tertiary care centre in the Middle East

14 Sep 2022
Mona Ali Hassan, Talar Telvizian, Mostafa Abohelwa, Deborah Mukherji, Hadi Skouri

Background: Androgen deprivation therapy (ADT) is the mainstay of treatment for advanced prostate cancer, improving symptoms and prolonging survival. There is an association between ADT use and cardiovascular (CV) events, particularly in patients with preexisting risk factors. In men diagnosed with prostate cancer, CV disease is the principal non-cancer-related cause of death. There are no definite guidelines to stratify patients based on CV risk prior to ADT initiation. This is the first study on cardiac risks and events in patients with prostate cancer treated with ADT from the Middle East region, a population known to have a high prevalence of CV risk factors.

Results: A retrospective study of 234 patients with prostate cancer, who received ADT therapy at a tertiary care centre in Lebanon was conducted. CV risk factors at baseline and CV events on ADT were reviewed. The median age was 68 years (48–92 years). The majority of patients had stage 4 diseases at diagnosis (49.6%) with a median duration of 12 months on ADT. In our cohort, 24.4% had body mass index > 30, 52.1% had smoking history, 25.6% were diabetic, 19.7% had history of coronary artery disease, 9.8% had heart failure history and 52.9% had hypertension. Less than half of the patients had a documented lipid profile at baseline. Twenty-two patients (9.5%) had documented cardiac events following ADT initiation.

Conclusions: In this cohort of patients from the Middle East, we found that one third of the population had established coronary artery disease at baseline and 9.5% had documented cardiac events on ADT initiation. Our study highlights the gaps in CV risk assessment for this high-risk group of patients with prostate cancer in addition to high prevalence of CV comorbidities. Risk and resource-stratified algorithms are needed before starting ADT therapy for optimal CV health. Increased awareness, collaboration and referral mechanisms between oncologists, urologists and cardiologists are also needed to provide optimal care.

Related Articles

Thilagavathi Ramamoorthy, Krishnan Sathishkumar, Priyanka Das, Kondalli Lakshminarayana Sudarshan, Prashant Mathur
Dinesh Thekkinkattil, Raghavan Vidya, Ava Kwong, Adil Aljarrah, Miriam Mutebi, Bahadir Gulluoglu, Suryanarayana Deo, Eisuke Fukuma, Elisabeth Elder, Eduardo Gonzalez, Fredrik Warnberg, Iness Buccimazza, Owen Ung, Melanie Walker, Maria Vernet-Tomas, Marie-Jeanne Vrancken Peeters, Nathalie Johnson, Regis Paulinelli, Thorsten Kuehn, Paolo Veronesi, Diptendra Sarkar, Jill Dietz
Debdeep Dey, Bhagat Singh Lali, Paromita Roy, Divya Midha, Indu Arun, Lateef Zameer, Anand Bardia, Geetashree Mukherjee
Valerian Mwenda, Woki Mburu, Joan-Paula Bor, Mary Nyangasi, Marc Arbyn, Steven Weyers, Philippe Tummers, Marleen Temmerman
Suresh Kumar Bondili, Ravindra Nandhana, Aditya Dhanawat, Vanita Noronha, Amit Joshi, Vijay Maruti Patil, Nandini Menon, Rajiv Kumar Kaushal, Anuradha Choughule, Sabita S Jiwnani, Amit Janu, Kumar Prabhash