Association between duration of gonadotrophin‐releasing hormone agonist use and cardiovascular risks: A population‐based competing‐risk analysis

Abstract

Background: Although androgen deprivation therapy has known cardiovascular risks, it is unclear if its duration is related to cardiovascular risks. This study thus aimed to investigate the associations between gonadotrophin-releasing hormone (GnRH) agonist use duration and cardiovascular risks.Methods: This retrospective cohort study included adult patients with prostate cancer receiving GnRH agonists in Hong Kong during 1999-2021. Patients who switched to GnRH antagonists, underwent bilateral orchidectomy, had <6 months of GnRH agonist, prior myocardial infarction (MI), or prior stroke was excluded. All patients were followed up until September 2021 for a composite endpoint of MI and stroke. Multivariable competing-risk regression using the Fine-Gray subdistribution model was used, with mortality from any cause as the competing event.Results: In total, 4038 patients were analyzed (median age 74.9 years old, interquartile range (IQR) 68.7-80.8 years old). Over a median follow-up of 4.1 years (IQR 2.1-7.5 years), longer GnRH agonists use was associated with higher risk of the endpoint (sub-hazard ratio per year 1.04 [1.01-1.06], p = 0.001), with those

Long‐term cardiovascular burden in prostate cancer patients receiving androgen deprivation therapy

“…1 However, it is associated with increased cardiovascular risks, including elevated risks of cardiovascular mortality, myocardial infarction and stroke. 2,3 Nonetheless, prior studies have focussed on the first occurrence of adverse cardiovascular events, 2,4,5 and the burden of cardiovascular hospitalizations in patients with PCa receiving ADT has remained unexplored. Similarly, the long-term burden of cardiovascular mortality amongst ADT users has been underexplored.…”

HbA1c Variability and Cardiovascular Events in Patients with Prostate Cancer Receiving Androgen Deprivation Therapy

“…Mortality data were acquired from the linked Hong Kong Death Registry, a governmental registry of mortality data for Hong Kong citizens. CDARS and the linked Hong Kong Death Registry have been used extensively in research, and have been demonstrated to have good coding accuracy and data completeness [17] , [18] , [19] , [20] , [21] , [22] .…”

Association between visit-to-visit lipid variability and incident cancer: a population-based cohort study

“…Mortality data were retrieved from the linked Hong Kong Death Registry, a governmental registry which records mortality data of all Hong Kong citizens. CDARS and the linked Hong Kong Death Registry have been used extensively in prior studies, and have been shown to have good coding accuracy (18)(19)(20)(21)(22).…”

“…Nevertheless, previous studies have demonstrated good coding accuracy and data completeness in CDARS (41), and CDARS has been used extensively in research (18)(19)(20)(21)(22). Although individual adjudication of patient data was not possible due to the deidentified nature of the database, all the data was entered by treating clinicians without any involvement from any of the authors, and none of the authors had the right or authority to alter the data.…”