Androgen-deprivation therapy linked to increased risk of heart failure

December 7, 2018

By Reuters Staff

NEW YORK (Reuters Health) - The use of androgen-deprivation therapy (ADT) in men with prostate cancer is associated with an increased risk of heart failure, researchers from Taiwan report.

Previous studies have suggested an association between ADT and heart failure, but only one has included Asian men in the study population, according to Taiwanese researchers.

Dr. Yu-Ching Chou from National Defense Medical Center, in Taipei, and colleagues used the Taiwan Longitudinal Health Insurance Database to investigate the relationship between ADT and heart failure in their study of 1,244 men with prostate cancer who received ADT and 1,806 men with prostate cancer who did not receive ADT.

The incidence of heart failure per 100 person-years within the one-year follow-up period was more than twice as high among men receiving ADT (4.00) than among men not receiving ADT (1.89), the team reports in The Journal of Clinical Pharmacology, online November 7.

After adjusting for age, urbanization level, geographical location, monthly income and comorbidities, the risk of heart failure was 72% higher with than without ADT.

In a propensity score-matched analysis of 1,088 pairs of men with prostate cancer, ADT use was associated with a 92% increased risk of heart failure.

The heart-failure risk was greater for those receiving long-term ADT (2.38-fold increased) compared with nonusers, but there was no significant difference in risk between men receiving short-term ADT and nonusers.

"We recommend that clinicians should counsel their patients regarding modifiable heart failure risk factors, suggest they improve their lifestyle, and further provide relevant cardiovascular examination for prostate cancer patients receiving androgen deprivation therapy," the researchers conclude. "Furthermore, although a quantifiable risk of heart failure has been established in this study, these findings may not necessarily alter the benefit-risk balance for the use of androgen deprivation therapy among patients with prostate cancer."

Dr. Chou did not respond to a request for comments.


J Clin Pharmacol 2018.

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