دورية أكاديمية
أعرض في EDS

Long-term Cardiovascular Risks of Gonadotropin-releasing Hormone Agonists and Antagonists: A Population-based Cohort Study.

التفاصيل البيبلوغرافية
العنوان: Long-term Cardiovascular Risks of Gonadotropin-releasing Hormone Agonists and Antagonists: A Population-based Cohort Study.
المؤلفون: Chan JSK; Cardio-oncology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China., Lee YHA; Cardio-oncology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China; Division of Urology, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Hui JMH; Cardio-oncology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China., Liu K; Division of Urology, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Dee EC; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Ng K; Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK., Tang P; Cardio-oncology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China., Tse G; Cardio-oncology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China; Kent and Medway Medical School, Canterbury, UK; Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China. Electronic address: gary.tse@kmms.ac.uk., Ng CF; Division of Urology, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: ngcf@surgery.cuhk.edu.hk.
المصدر: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2023 Jun; Vol. 35 (6), pp. e376-e383. Date of Electronic Publication: 2023 Mar 29.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: England NLM ID: 9002902 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-2981 (Electronic) Linking ISSN: 09366555 NLM ISO Abbreviation: Clin Oncol (R Coll Radiol) Subsets: MEDLINE
أسماء مطبوعة: Publication: 2003- : London : W.B. Saunders
Original Publication: [London, UK] : Springer International, [c1989-
مواضيع طبية MeSH: Cardiovascular Diseases*/chemically induced , Cardiovascular Diseases*/epidemiology , Myocardial Infarction*/chemically induced , Myocardial Infarction*/epidemiology , Myocardial Infarction*/drug therapy , Prostatic Neoplasms*/therapy , Stroke*/chemically induced , Stroke*/epidemiology , Stroke*/drug therapy, Male ; Humans ; Aged ; Aged, 80 and over ; Gonadotropin-Releasing Hormone/therapeutic use ; Risk Factors ; Prospective Studies ; Cohort Studies ; Androgen Antagonists/therapeutic use ; Heart Disease Risk Factors
مستخلص: Aims: Gonadotropin-releasing hormone (GnRH) agonists and antagonists, critical medications for prostate cancer (PCa) treatment, may differ in cardiovascular safety. This prospective cohort study aimed to compare the long-term cardiovascular risks between GnRH agonists and antagonists.
Materials and Methods: Patients with PCa receiving GnRH agonists or antagonists during 2013-2021 in Hong Kong were identified. Patients with <6 months' prescriptions, who were switching between drugs, had missing baseline prostate-specific antigen level or had a prior stroke or myocardial infarction were excluded. Patients were followed up until September 2021. The primary outcome was major adverse cardiovascular events (MACE) as in the PRONOUNCE trial (MACE PRONOUNCE ), i.e. a composite of all-cause mortality, stroke and myocardial infarction. The secondary outcome was MACE CVM , i.e. a composite of cardiovascular mortality, stroke and myocardial infarction. Inverse probability treatment weighting was used to balance covariates between groups. The Log-rank test was used to compare the cumulative freedom from the primary outcome between groups.
Results: In total, 2479 patients were analysed (162 GnRH antagonist users and 2317 agonist users; median age 75.0 years, interquartile range 68.0-81.6 years). Inverse probability treatment weighting achieved good covariate balance between groups. Over a median follow-up duration of 3.0 years (interquartile range 1.7-5.0 years), 1115 patients (45.0%) had MACE PRONOUNCE and 344 (13.9%) had MACE CVM . GnRH agonist users had lower risks of MACE PRONOUNCE (Log-rank P < 0.001) and MACE CVM (Log-rank P = 0.027). However, no differences were observed within 1 year of follow-up (MACE PRONOUNCE : Log-rank P = 0.308; MACE CVM : Log-rank P = 0.357). Among patients without cardiovascular risk factors at baseline, GnRH agonist users had lower risks of MACE PRONOUNCE (Log-rank P < 0.001) and MACE CVM (Log-rank P = 0.001), whereas no differences were observed in those with such risk factor(s) (MACE PRONOUNCE : Log-rank P = 0.569; MACE CVM : Log-rank P = 0.615).
Conclusions: GnRH antagonists may be associated with higher long-term, but not short-term, cardiovascular risks than agonists in Asian patients with PCa, particularly in those without known cardiovascular risk factors.
(Copyright © 2023. Published by Elsevier Ltd.)
فهرسة مساهمة: Keywords: Androgen deprivation therapy; MACE; cardio-oncology; cohort; hormonal therapy; prostate cancer
المشرفين على المادة: 33515-09-2 (Gonadotropin-Releasing Hormone)
0 (Androgen Antagonists)
تواريخ الأحداث: Date Created: 20230408 Date Completed: 20230509 Latest Revision: 20230519
رمز التحديث: 20240628
DOI: 10.1016/j.clon.2023.03.014
PMID: 37031076
قاعدة البيانات: MEDLINE
الوصف
تدمد:1433-2981
DOI:10.1016/j.clon.2023.03.014