Assessment and Management of Cardiovascular Risk Factors Among US Veterans With Prostate Cancer

Abstract

Key Points Question Are cardiovascular risk factors assessed and appropriately managed in patients with prostate cancer initiating androgen deprivation therapy? Findings In this cross-sectional analysis of 90 494 US veterans with prostate cancer, 68.1% received comprehensive cardiovascular risk factor assessment and 54.1% had uncontrolled risk factors; of these, 29.6% were not receiving risk-reducing medication. Patients with known atherosclerotic cardiovascular disease had improved cardiovascular risk factor assessment, control, and treatment; however, androgen deprivation therapy initiation was not associated with meaningful differences in these outcomes. Meaning In this study, veterans with prostate cancer, including those initiating androgen deprivation therapy, appeared to have a high burden of underassessed and undertreated cardiovascular risk factors.

The Insignificant Correlation between Androgen Deprivation Therapy and Incidence of Dementia Using an Extension Survival Cox Hazard Model and Propensity-Score Matching Analysis in a Retrospective, Population-Based Prostate Cancer Registry

“…Other reasons for the contradictory results compared to previous studies could be the ADT duration and study period [ 9 , 16 , 20 ]. The study period was between 2006 and 2013, during which time most of the patients had ADT histories of less than 3 years, since ADT had been approved by the national insurance system as a first-line treatment only for advanced and metastatic PC cases until biochemical recurrence.…”

“…We applied strict diagnostic indications of dementia, and eliminated the effect of the inherent bias of baseline differences between ADT and non-ADT cohorts by PSM, even after considering all the adjusted major known etiologies of cognitive dysfunction and all the disease burden states according to SEER staging, especially in an Asian population-based cancer registry [ 7 , 16 , 19 , 20 , 21 , 22 , 23 ]. In the absence of randomized clinical trials, our analytic method is the best approach to demonstrate the insignificant relationship between ADT exposure and dementia in real-world clinical settings.…”

“…This study compared the dementia and non-dementia groups to identify any differential characteristics among the patients ( Table 3 ), revealing the significant importance of tumor characteristics and their relationship to the patients’ general performance status in PC cohorts, which affects the dementia incidence. Since the patients’ general condition significantly affected the incidence of dementia, the tumor burden and extent were important factors for not only general performance and nutritional state but also mental health, including cognitive function [ 7 , 19 , 20 , 30 ].…”

Does Exist a Differential Impact of Degarelix Versus LHRH Agonists on Cardiovascular Safety? Evidences From Randomized and Real-World Studies

“…Sun et al (11) performed a cross-sectional analysis on 90494 US men with PC, 22700 submitted to ADT. Patients receiving ADT were more likely to be older and more frequently had a history of ASCVD (21.0% versus 15.5%).…”

Non‐cancer mortality in elderly prostate cancer patients treated with combination of radical prostatectomy and external beam radiation therapy

“…Nonetheless, the objective within the urological community involved in the care of these patients, should be considered both scenarios with the intend of reducing OCM rates either at the time of RP and EBRT selection, based on OCM risk and/or susceptibility to ADT plus EBRT and ADT toxicity. [18][19][20][21][22][23][24] Fourth Our study has limitations and should firstly be interpreted in the context of its retrospective and population-based design. Secondly, no distinction could be made according to adjuvant or salvage EBRT after RP.…”