Temporal trends in cardiovascular burden among patients with prostate cancer receiving androgen deprivation therapy: a population-based cohort study

Chan, Jeffrey Shi Kai; Satti, Danish Iltaf; Lee, Yan Hiu Athena; Hui, Jeremy Man Ho; Dee, Edward Christopher; Ng, Kenrick; Liu, Kang; Tse, Gary; Ng, Chi‐Fai

doi:10.1038/s41416-023-02271-5

Cited by 12 publications

(9 citation statements)

References 41 publications

(50 reference statements)

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“…Furthermore, some PCa medications, including ADT (androgen deprivation therapy), have a potency that adversely affects the cardiometabolic status and increases the risk for cardiovascular complications ( 33 – 36 ). Chan et al ( 37 ) recently demonstrated temporal increasing trends of recipients of ADT therapy with cardiovascular risk factors, frequently used cardiovascular and metabolic medications, and developed cardiovascular events. CVD is the leading cause of mortality in PCa survivors ( 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and temporal trends of prostate diseases among inpatients with cardiovascular disease: a nationwide real-world database survey in Japan

Kaneta,

Tanaka,

Nakai

et al. 2023

Front. Cardiovasc. Med.

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IntroductionBenign prostate hyperplasia (BPH) and prostate cancer (PCa) are major prostate diseases that potentially share cardiometabolic risk factors and an elevated risk for cardiovascular disease (CVD). However, the prevalence of prostate diseases among patients with established CVD remains unclear.Materials and methodsThis nationwide retrospective study assessed the prevalence and temporal trend of prostate diseases (i.e., BPH or PCa) among patients hospitalized for CVDs in Japan. We used a claims database (the Japanese Registry of All Cardiac and Vascular Diseases–Diagnosis Procedure Combination), which included data on 6,078,487 male patients recorded from 1,058 hospitals between April 2012 and March 2020. We conducted the Cochran–Armitage trend test and calculated the adjusted odds ratio (aOR) with 95% confidence intervals (CIs).ResultsThe prevalence of prostate diseases over the entire study period was 5.7% (BPH, 4.4%; PCa, 1.6%). When dividing the overall cohort into age categories (<65, 65–74, and ≥75 years old), the prevalence was 1.1%, 4.7%, and 9.9%, respectively (P for trend <0.05). In addition, the annual prevalence showed a modest increasing trend over time. Patients admitted for heart failure (HF) were significantly associated with a higher incidence of coexisting prostate diseases than those admitted for non-HF causes [aOR 1.02 (95% CI, 1.01–1.03)] or acute coronary syndrome [aOR 1.19 (95% CI, 1.17–1.22)].ConclusionsThe nationwide real-world database revealed that the prevalence of prostate diseases is increasing among patients hospitalized for CVD, particularly HF. Attention to detailed causality and continued surveillance are needed to further clarify the clinical characteristics of prostate diseases among patients with CVD.

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Section: Discussionmentioning

confidence: 99%

Prevalence and temporal trends of prostate diseases among inpatients with cardiovascular disease: a nationwide real-world database survey in Japan

Kaneta,

Tanaka,

Nakai

et al. 2023

Front. Cardiovasc. Med.

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“…Data were acquired from the Clinical Data Analysis Reporting System (CDARS) of the Hong Kong Hospital Authority, a statutory body that manages all public hospitals and their affiliated outpatient and day care facilities in Hong Kong, covering approximately 90% of the population and being the most representative electronic medical database available in Hong Kong. 8 CDARS prospectively collects patient information including, but not limited to, demographic data, selected laboratory tests, diagnoses, drug prescriptions, procedures, and episodes of hospital visits since 1993. CDARS encodes diagnoses using the International Classification of Diseases, ninth revision (ICD-9), as CDARS has not implemented ICD-10 codes to date.…”

Section: Methodsmentioning

confidence: 99%

Association between Time-Weighted Remnant Cholesterol and Incident Cancer: A Population-Based Chinese Cohort Study

Li,

Zhang,

Yang

et al. 2024

Preprint

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Background: Remnant cholesterol (RC) is becoming an increasingly well-recognized risk factor for cardiometabolic diseases. However, no study has explored the predictive role of RC in new-onset cancer. This study aimed to examine the associations between RC and time-weighted RC with incident cancer in the general population. Methods: This was a retrospective population-based study enrolling patients attending family medicine clinics in Hong Kong between 1st January 2000 and 31st December 2003 with at least three RC measurements during follow-up visits. The primary outcome was new-onset cancer. The secondary outcome was cancer-related mortality. Multivariable Cox regression was used to evaluate associations between baseline RC and time-weighted RC with outcomes. Results: A total of 75,342 adults (39.7% males, mean age: 62.5 years old) were included. During a median follow-up of 16.8 years, 8335 (11.1%) incident cancer and 4349 (5.7%) cancer-related deaths were observed. After adjusting for potential confounders, one mmol/L increased of time-weighted RC was associated with 41% and 62% higher risk of incident cancer (HR, 1.41; 95%CI, 1.26-1.57; p<0.0001) and cancer-related mortality (HR, 1.62; 95%CI, 1.43-1.85; p<0.0001), respectively. However, no significant association between baseline RC with risk of new-onset cancer (HR, 1.04; 95%CI, 0.82-1.31; p=0.768) and cancer-related mortality (HR, 0.85; 95%CI, 0.61-1.17; p=0.315) in the adjusted model. The association between time-weighted RC and incident cancer was significant regardless of age, gender, and remained consistent amongst those with baseline use of most cardiometabolic agents, as well as those complicated with most comorbidities. Conclusions: Higher time-weighted RC was associated with increased risk of new-onset cancer and cancer-related mortality amongst the general population.

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“… 14 , 15 , 16 , 17 Our team has previously used this cohort of PCa patients receiving ADT for studying cardiovascular outcomes. 18 , 19 , 20 …”

Section: Methodsmentioning

confidence: 99%

Statin use and mortality risk in Asian patients with prostate cancer receiving androgen deprivation therapy: A population‐based cohort study

Lee,

Chan,

Hui

et al. 2023

Cancer Medicine

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BackgroundThis study aimed to examine the associations between the use of statins concurrent with androgen deprivation therapy (ADT) and the risks of mortality in Asian patients diagnosed with prostate cancer (PCa).MethodsAdult patients (≥18 years old) diagnosed with PCa who were receiving any form of ADT and were being treated at public hospitals in Hong Kong from December 1999 to March 2021 were retrospectively identified, with follow‐up conducted until September 2021. Patients who had received medical castration for <180 days without subsequent bilateral orchidectomy, those who had used statins concurrently with ADT for <180 days, and those with missing baseline total cholesterol levels were excluded. Statin users were defined as individuals who had used statins for ≥180 days concurrent with ADT, while non‐users were those who had not used any statins. PCa‐related mortality was the primary outcome, while all‐cause mortality served as the secondary outcome. Inverse probability treatment weighting was employed to balance the covariates.ResultsA total of 4920 patients were included, consisting of 2578 statin users and 2342 non‐users (mean age 76.1 ± 8.2 years). Over a mean follow‐up period of 4.2 ± 3.3 years, it was observed that statin users had significantly lower risks of both PCa‐related mortality (weighted hazard ratio [wHR] 0.56 [95% confidence interval (CI) 0.48, 0.65], p < 0.001) and all‐cause mortality (wHR 0.57 [95% CI 0.51, 0.63], p < 0.001), regardless of the type of ADT used. Notably, these associations were more pronounced among patients with less advanced PCa, as indicated by the absence of androgen receptor antagonist or chemotherapy usage (p value for interaction <0.001 for both outcomes).Conclusion(s)The use of statins concurrent with ADT was associated with reduced mortality risks among Asian patients with PCa. These findings suggest the need for additional research to explore the potential role of statins in the treatment of PCa patients.

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Temporal trends in cardiovascular burden among patients with prostate cancer receiving androgen deprivation therapy: a population-based cohort study

Cited by 12 publications

References 41 publications

Prevalence and temporal trends of prostate diseases among inpatients with cardiovascular disease: a nationwide real-world database survey in Japan

Prevalence and temporal trends of prostate diseases among inpatients with cardiovascular disease: a nationwide real-world database survey in Japan

Association between Time-Weighted Remnant Cholesterol and Incident Cancer: A Population-Based Chinese Cohort Study

Statin use and mortality risk in Asian patients with prostate cancer receiving androgen deprivation therapy: A population‐based cohort study

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