Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer Patients: A Systematic Review

Abstract

The purpose of this study was to investigate the relationship between androgen deprivation therapy (ADT) and cardiovascular events in men with prostate cancer. Cardiovascular disease (CVD) is a primary cause of noncancer mortality in men with prostate cancer. Surveillance, Epidemiology, and End Results (SEER) Medicare-linked data revealed that CVD was responsible for about a quarter of deaths among men with prostate cancer, with a focus on the role of ADT as a contributing cause.We performed a literature search in November 2021 utilizing search engines such as PubMed, Scopus, Science Direct, and Google Scholar. Original publications with data published between 2006 and 2020 were used in the investigation of men with prostate cancer undergoing ADT treatment with a CVD outcome. Two reviewers independently examined the content of the studies and extracted data from the final papers after they had been validated for quality using quality assessment tools. A total of 14 observational studies and two randomized controlled trials are included in this systematic review. Sample sizes in the examined publications varied from 79 to 201,797 individuals. ADT was the intervention in all of the investigations. Seven of the included studies did not identify the type of ADT utilized; instead, they compared the outcomes of individuals who got ADT against those who did not. The specific type of ADT used is mentioned in the remaining nine studies included in the systematic review. Patients who got ADT, such as gonadotropin-releasing hormone (GnRH) agonists, combination androgen blockade, surgical castration, and oral anti-androgen, are compared to those who did not receive ADT to discover who had a better prognosis.In conclusion, even though ADT has several negative metabolic side effects that increase the risk of cardiovascular toxicity, published research utilizing a variety of designs has demonstrated inconsistency in the impact of ADT on cardiovascular outcomes. While the risk of CVD should be considered when prescribing ADT, the findings suggest that it should not be considered a contraindication if the expected benefit is substantial.

Correlation between E‐cadherin/β‐catenin, Vimentin expression, clinicopathologic features and drug resistance prediction in naïve prostate cancer: A molecular and clinical study

“…Moreover, in this current study, we observed a positive correlation between coronary heart disease and Vimentin in PC. This could be explained by the association of cardiovascular diseases and PC (Kakarla et al, 2022), and by the involvement of Vimentin in increasing stiffness, contractility, and endothelial dysfunction in arteries (Langlois et al, 2017). Furthermore, we found a positive correlation between E‐cadherin and β‐catenin, and a negative expression between the latter two markers and Vimentin.…”

Targeting Breast Cancer: An Overlook on Current Strategies

“…One advantage of the use of GnRH agonists is the protection of ovarian reserve that was observed with the use of goserelin during chemotherapy, even though the exact mechanism has not been fully elucidated yet [ 112 ]. The impact of GnRH agonists on ischemic heart disease has not been established, but some authors report an increased risk of cardiovascular toxicity after treatment with GnRH agonists, especially in men with prostate cancer [ 113 , 114 ], whereas it has not been demonstrated in women with BC. A recent study found that female patients with breast cancer receiving GnRH agonists had a lower risk of developing ischemic heart disease than patients not receiving them [ 115 ].…”

Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide

“…However, adverse drug effects are common with these hormonal therapies and may vary with patient and drug characteristics [10,11]. Furthermore, cardiovascular disease (CVD) is a primary cause of noncancer mortality in men with prostate cancer [12]. A recent study identified that CVD accounted for almost 30.2% of all deaths among prostate cancer patients [13].…”