Following ADT, Older Patients With Prostate Cancer Are at an Increased Risk of Cardiac Complications

Older men with prostate cancer who have received androgen-deprivation therapy (ADT) may be at an increased risk of major averse cardiovascular events, including myocardial infractions, stroke, or death from any cause, according to data presented at the 47th Annual Oncology Nursing Congress.

ADT is often used as a treatment for patients with advanced prostate cancer. Nurses caring for patients receiving ADT may be aware to look out for a list of adverse events (AEs), including hot flashes, cognitive impairment, muscle wasting, and anemia. However, in recent years, providers have also begun to turn their attention to cardiac complications associated with this treatment.

Previous literature has demonstrated an association between the treatment and cardiovascular risk; however, there is still debate on whether ADT causes that risk or if it is other comorbidities, said Deborah Boldt-Houle, an author on the study and senior director of medical affairs at TOLMAR Pharmaceuticals, which manufactures the ADT therapy Eligard (leuprolide acetate), during the presentation.

This study, which included the medical records of 44,339 patients, evaluated the relationship between risk of major cardiovascular events and age in patients with prostate cancer on ADT. Patients included in the study were divided into age group: younger than 60 (6%); 60 to 70 years old (24%); 70 to 80 years old (39%); or 80 years or older (31%).

In the overall population, major averse cardiovascular events risk was between 2% and 6% one year after ADT initiation, and 12% and 31% four years after.

Additionally, risk of major adverse cardiovascular events was more common in older patients compared to younger patients in the first seven years after ADT.

Boldt-Houle added that these results are significant and a possible explanation for this is because older patients tend to have more comorbidities that could cause cardiovascular issues, such as diabetes, obesity and frailty, she explained.

The results highlight that a patient’s care team should be cognizant of their age and risk for major averse cardiovascular events prior to starting treatment with ADT. Future studies are needed to evaluate the role comorbidities play in cardiovascular problems during ADT.

Reference

Vandross J, Atkinson S, Boldt-Houle D. Risk of major adverse cardiovascular events after initiation of androgen deprivation therapy is higher for older patients.