OBJECTIVE: To investigate the risk of acute myocardial infarction (AMI) after androgen deprivation therapy (ADT) for prostate cancer in the Chinese population.
METHODS: All Chinese prostate cancer patients who were treated primarily with radical prostatectomy or radiotherapy, with or without further ADT at our hospital from year 2000 to 2009 were retrospectively reviewed. We compared the risk of AMI in the patients who were given further ADT (ADT group) with those who were not given any ADT (non-ADT group). Potential risk factors of AMI including age, diabetes mellitus, hypertension, hyperlipidemia, history of stroke, ischemic heart disease, ECOG performance status and duration of ADT were reviewed. The risk of AMI after ADT was first analyzed with Kaplan-Meier method, followed by Cox regression analyses including the potential risk factors mentioned.
RESULTS: A total of 452 patients were included, consisting of 200 patients in the non-ADT group and 252 patients in the ADT group. The mean age was 68.2+5.9 years in the non-ADT group and 69.5+6.5 years in the ADT group, and the difference was statistically significant (P = 0.031). There was no significant difference in their pre-existing medical conditions and ECOG performance status. The ADT group was associated with an increased risk of AMI when compared to the non-ADT group (P = 0.004) upon Kaplan-Meier analysis. Upon multivariate Cox regression analysis, hyperlipidemia, poor ECOG performance status and the use of ADT were the only three significant factors that were associated with increased risk of developing new AMI.
CONCLUSIONS: There was increased risk of AMI after ADT for prostate cancer in the Chinese population. Hyperlipidemia and poor ECOG performance status were also significant risk factors for developing AMI. The risk of AMI should be considered while deciding on ADT, especially in patients with history of hyperlipidemia and relatively poor ECOG performance status. Prostate cancer, androgen deprivation therapy, myocardial infarction, Asian population.
Teoh JY, Chan SY, Chiu PK, Poon DM, Cheung HY, Hou SS, Ng CF. Are you the author?
Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Reference: BJU Int. 2014 Oct 18. Epub ahead of print.