The Effects of Androgen Deprivation Therapy on Cardiac Function and Heart Failure: Implications for Management of Prostate Cancer

Edelman, Scott; Butler, Javed; Hershatter, Bruce

doi:10.1016/j.clgc.2014.07.009

Cited by 24 publications

(17 citation statements)

References 64 publications

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“…Authors also found that the risk for developing a CV disease was the highest during the fi rst 6 months of the treatment in men who experienced two or more cardiovascular events before they started the therapy with agonists of GnRH. This supports the opinion that those patients threated with ADT and an preexisting CV disease may be at the greatest risk (2)(3)(4)(5)33). Increased cardiovascular toxicity in patients undergoing a short-term ADT was confi rmed by another authors (38).…”

Section: Clinical Studiessupporting

confidence: 64%

“…In the view of these results, the authors believe that ADT is associated with signifi cant adverse effects, and patients on ADT should be regularly monitored by a cardiologist (15). The latest recommendations for the management of patients for ADT-related cardiotoxicity was published by Edelman et al (5) in the journal The Clinical Genitourinary Cancer. In patients with high-risk prostate cancer and a history of heart failure can be shortening of GnRH therapy suitable.…”

Section: Clinical Studiesmentioning

confidence: 99%

“…Outcomes of studies related to heart failure are less consistent. Results of the two registers showed an association between ADT and heart failure, but it was not confi rmed by another register (5). Following many observations, a science advisory consensus statement on GnRH agonist therapy and cardiovascular risk was issued, and the US Food and Drug Administration safety warns addresing the concern of increased risk of myocardial infarction, stroke and sudden cardiac death (18).…”

Section: Introductionmentioning

confidence: 99%

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Androgen deprivation therapy and cardiovascular complications

Poljak¹,

Hulín²,

Maruscakova³

et al. 2017

BLL

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Cardiovascular complications associated with the use of antiandrogens have already been known for some time. Based on the results of the latest meta-analyses and clinical studies published in the last few years, the attention of the scientifi c community is focused on the deleterious cardiovascular effects of gonadotropine-releasing hormon agonists in context of the androgen deprivating therapy. The cardiac toxicity is a problem especially in patients with preexisting cardiovascular comorbidities. Increased arterial wall thickening along with endothelial dysfunction has been observed in patients with descreased androgens levels in the peripheral blood. The treatment with gonadotropine-releasing hormon agonists may disrupt the intracellular concentration of calcium ions and the contractile process and potentially result in pathological remodelling of heart. Here, we give several possible mechanisms of action of gonadotropine-releasing hormon agonists on the cardiovascular system that may be a potential explanation of the clinical observations (Ref. 44). Text in PDF www.elis.sk.

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Section: Clinical Studiessupporting

confidence: 64%

Section: Clinical Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Androgen deprivation therapy and cardiovascular complications

Poljak¹,

Hulín²,

Maruscakova³

et al. 2017

BLL

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“…But it is necessary to exclude prostate cancer before treatment with testosterone (21). There was also a concern regarding the long-term risk of prostate cancer with testosterone treatment.…”

Section: Discussionmentioning

confidence: 99%

Will testosterone replacement therapy become a new treatment of chronic heart failure? A review based on 8 clinical trials

Wang

Jiang

et al. 2016

J. Thorac. Dis.

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Background: According to the present evidences suggesting association between low testosterone level and prediction of reduced exercise capacity as well as poor clinical outcome in patients with heart failure, we sought to determine if testosterone replacement therapy (TRT) improves clinical and cardiovascular conditions as well as quality of life status in patients with stable chronic heart failure (CHF). Methods:We carried out a review based on 8 published clinical trials to determine whether TRT will benefit patients with CHF. Information of exercise capacity, hemodynamic parameters, electrocardiogram indicators, muscle strength, echocardiography guidelines and laboratory indexes were collected to assess clinical outcomes.Results: We found that TRT could improve significantly exercise capacity, muscle strength and electrocardiogram indicators but no significant changes in ejection fraction (EF), systolic blood pressure (SBP), diastolic blood pressure (DBP), N-terminal pro-brain natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6).Conclusions: High-quality studies are required to better understand the clinical effects of testosterone.

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“…These are many of the components of metabolic syndrome, which increases long-term cardiovascular risk (Redig andMunshi 2010, Bourke et al 2012). Androgen deprivation therapy also decreases lean body mass, increases fat mass and increases arterial stiffness (Edelman et al 2014). These effects can be seen quickly and occur within three months of the initiation of therapy.…”

Section: Indirect Damagementioning

confidence: 88%

Mitigating risk of cardiovascular disease in people living with and beyond cancer

Faithfull¹,

Burton²,

Clarke³

et al. 2017

Cancer Nursing Practice

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Rates of cancer survival have increased in recent decades as a result of earlier diagnosis and improved therapies, but a longer lifespan does not necessarily equate to a healthier life. Chronic illness as a consequence of cancer and its treatment is reported in a significant proportion of people living with and beyond the disease. An increased risk of cardiovascular diseases, such as myocardial infarction, stroke and heart failure, is one of the side effects of some cancer therapies.Nurses in oncology and primary care can minimise cardiovascular risks by improving people's awareness of symptoms, conducting health assessments and making appropriate referrals. Secondary prevention through lifestyle advice, smoking cessation and obesity reduction is also essential. This should be in combination with more detailed cardiac assessment for those in high-risk groups at all stages of the patient pathway.Appropriate risk management and early detection of heart problems can prevent long-term illness and reduce multimorbidity for people living with and beyond cancer.

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The Effects of Androgen Deprivation Therapy on Cardiac Function and Heart Failure: Implications for Management of Prostate Cancer

Cited by 24 publications

References 64 publications

Androgen deprivation therapy and cardiovascular complications

Androgen deprivation therapy and cardiovascular complications

Will testosterone replacement therapy become a new treatment of chronic heart failure? A review based on 8 clinical trials

Mitigating risk of cardiovascular disease in people living with and beyond cancer

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