Androgen-deprivation therapy for prostate cancer may increase the risk of cardiac death among men who have congestive heart failure or who have experienced a previous myocardial infarction, a retrospective cohort study has found.
The study of 5,077 men, whose prostate cancer was treated with brachytherapy with or without neoadjuvant androgen-deprivation therapy (ADT), showed that ADT was associated with a greater-than-threefold increase in the risk of cardiac specific mortality among men with heart failure or myocardial infarction (adjusted hazard ratio, 3.28; 95% confidence interval, 1.01-10.64; P = .048), representing a 5% increase in absolute risk over 5 years.
However, researchers saw no association between ADT and cardiac death among men with no cardiac risk factors, or those with diabetes mellitus, hypertension, or hypercholesterolemia, according to a paper published online Oct. 29 in BJU International (2014 [doi:10.1111/bju.12905]).
“These results add vital detail to past work that showed that the delivery of ADT to men with moderate to severe comorbidity is associated with no survival benefit, and that delivery of ADT to men with [HF] or past MI is associated with increased risk of death from any cause,” wrote Dr. David R. Ziehr from Harvard Medical School, Boston, and his colleagues.
The study was supported by Fitz’s CancerWarriors, David and Cynthia Chapin, the Prostate Cancer Foundation, Hugh Simons in honor of Frank and Anne Simons, and a grant from an anonymous family foundation. Some authors declared consultancies, lectureships, and advisory board positions for pharmaceutical companies.