Abstract
Cardiovascular comorbidities and cardiovascular events in patients with metastatic prostate cancer.
Author
person
Mohammed Alaeddine Saidi
Laboratoire TOXICOMED, Department of Medicine, University of Tlemcen, Department of Medical Oncology, Tidjani Damerdji Teaching Hospital, Tlemcen, Algeria
info_outline
Mohammed Alaeddine Saidi, Ghomari Soumeyya, Sarra Sedjelmaci
Full text
Authors
person
Mohammed Alaeddine Saidi
Laboratoire TOXICOMED, Department of Medicine, University of Tlemcen, Department of Medical Oncology, Tidjani Damerdji Teaching Hospital, Tlemcen, Algeria
info_outline
Mohammed Alaeddine Saidi, Ghomari Soumeyya, Sarra Sedjelmaci
Organizations
Laboratoire TOXICOMED, Department of Medicine, University of Tlemcen, Department of Medical Oncology, Tidjani Damerdji Teaching Hospital, Tlemcen, Algeria, Department of Medicine, Laboratoire Toxicomed, University of Tlemcen, Department of Medical Oncology, CHU Tlemcen, Tlemcen, Algeria, Tlemcen, Algeria
Abstract Disclosures
Research Funding
No funding received
None.
Background:
Prostate cancer (PCa) is globally the second most frequently diagnosed cancer in men. Patients with metastatic disease require cancer treatment for several months or even years. These treatments can have different side effects including adverse cardiac effects because of decreased serum testosterone levels.
Methods:
We conducted an observational study of men who were diagnosed with metastatic PCa from January 1, 2013, through December 31, 2018, with follow-up through December 31, 2022. We documented comorbid conditions, medications, tumor characteristics, type and duration of systemic treatment received. We also documented fasting glucose, total cholesterol, HDL, LDL and triglyceride levels at diagnosis. A cardiovascular event was defined as the first occurrence of hypertension, myocardial infraction, atrial fibrillation, heart failure, sudden cardiac death, acute thrombo-embolism and stroke. Cox proportional hazards models were used to assess association between cancer treatment and incident cardiovascular disease (CVD).
Results:
The cohort included One hundred and twenty one men who were diagnosed with metastatic prostate adenocarcinoma with a mean age at diagnosis of 68.9 years. 84.2% had bone-only metastasis. 69.4% had at least one CVD-Risk Factor. 53.4% Hypertension, 28.2% Dyslipidemia, 12.3% Diabetes. 15 men (12.3%) had pre-existing CVD. 3.3% stroke, 4.1% myocardial infraction, 2.4% heart failure, 2.4% atrial fibrillaton. 24.2% were under statin therapy and 22.0% under aspirin. Androgen deprivation therapy (ADT) was used for all patients, including 9.9% goserelin, 3.3% leuprolide and 86.8 triptorelin. 70.2 % had received concomitant treatment: 22.3% bicalutamide, 60.3% abiraterone, 68.8% docetaxel, 4.1% cabazitaxel. Men were observed for a median of 5.6 years (range = 33 days to 10 years). Cardiovascular adverse events occurred in 14 patients (11.5%) on ADT alone and in 23 (19.0%) on combination therapy. 26 (21.4%) Hypertension, 1 (0.8%) myocardial infraction, 1 (0.8%) atrial fibrillation, 2 (1.6%) had heart failure, 1 (0.8%) sudden cardiac death, 5 (4.1%) acute thrombo-embolism, 1 (0.8%) stroke. In subgroup-analyses of different combination treatments, Cardiovascular events were found to be significantly associated with combination of abiraterone with ADT (HR = 1.31, 95 % CI: 1.13 to 1.37; P < 0.001). For men with a history of pre-existing CVD, CV events were more pronounced, 23.9% vs. 6.6% for men without pre-existing CVD.
Conclusions:
Metastatic prostate cancer patients often have pre-existing CVD and CVD-Risk Factors. Addition of abiraterone to ADT increase the risk of cardiovascular events. Physicians should monitor their patients in order to early detect any abnormality, and should encourage them to adopt a healthier lifestyle.
4 organizations
8 drugs
8 targets
Organization
Laboratoire ToxicomedOrganization
University of TlemcenOrganization
Tidjani Damerdji Teaching HospitalOrganization
CHU TlemcenDrug
LHRH agonistDrug
bicalutamideDrug
abirateroneDrug
docetaxelDrug
cabazitaxelDrug
statinsDrug
AspirinTarget
CYP17A1Target
GnRH receptorTarget
COX-1Target
androgen receptorTarget
COX-2Target
HMG-CoA reductaseTarget
microtubulesTarget
Bicalutamide