Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer.

Androgen deprivation therapy is a central part of prostate cancer treatment. Pharmacological androgen deprivation includes gonadotropin-releasing hormone agonism and antagonism, AR (androgen receptor) inhibition, and CYP17 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.

Arteriosclerosis, thrombosis, and vascular biology. 2020 Jan 23 [Epub ahead of print]

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

From the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (J.-R.H., M.S.D., J.D.B., W.C.M., M.S.F., J.-E.S., J.A.B., J.J.M.)., Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL (A.K.M.).

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