Cardiovascular mortality in patients with metastatic prostate cancer exposed to androgen deprivation therapy: A population-based study

Giorgio Gandaglia, Maxine Sun, Ioana Popa, Jonas Schiffmann, Vincent Trudeau, Shahrokh F. Shariat, Quoc Dien Trinh, Markus Graefen, Hugues Widmer, Fred Saad, Alberto Briganti, Francesco Montorsi, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

Abstract

Abstract Introduction The aim of our study was to reexamine the prevalence of baseline cardiovascular (CV) morbidity and the rates of CV mortality in a contemporary cohort of patients with prostate cancer (PCa) exposed to androgen deprivation therapy (ADT). Materials and Methods Records of patients aged 65 years and older with metastatic PCa who received ADT were abstracted from the Surveillance, Epidemiology, and End Results-Medicare database between 1991 and 2009. The primary end points comprised 5-year CV mortality rates. Survival rates were stratified according to age and Charlson comorbidity index (CCI). Competing-risks Poisson regression methodologies were performed. Results Overall, 9596 patients with metastatic PCa treated with ADT were identified. At baseline, 3049 patients (31.8%) had preexisting CV disease. The 5-year CV mortality rates were 9.8% and 14.8% in the overall population and in patients with preexisting CV disease, respectively. The 5-year CV mortality rates increased with advanced age and higher CCI score. In multivariate competing-risks regression analyses, age, year of diagnosis, CV comorbidities, CCI, and marital status represented independent predictors of CV mortality, after accounting for the risk of dying from other causes (all P ≤.04). Of those, preexisting CV disease contributed to the highest risk of CV mortality. Our study is limited by its retrospective nature. Conclusion CV mortality represents a common event in patients with metastatic PCa treated with ADT. Preexisting CV disease represented the strongest risk factor.

Original languageEnglish
Article number348
Pages (from-to)e123-e130
JournalClinical Genitourinary Cancer
Volume13
Issue number3
DOIs
Publication statusPublished - Jun 1 2015

Keywords

  • Baseline comorbidities
  • Cardiovascular diseases
  • Competing-risks
  • Risk factors
  • Surveillance Epidemiology and End Results-Medicare database

ASJC Scopus subject areas

  • Oncology
  • Urology

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    Gandaglia, G., Sun, M., Popa, I., Schiffmann, J., Trudeau, V., Shariat, S. F., Trinh, Q. D., Graefen, M., Widmer, H., Saad, F., Briganti, A., Montorsi, F., & Karakiewicz, P. I. (2015). Cardiovascular mortality in patients with metastatic prostate cancer exposed to androgen deprivation therapy: A population-based study. Clinical Genitourinary Cancer, 13(3), e123-e130. [348]. https://doi.org/10.1016/j.clgc.2014.12.003