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| Clinical genitourinary cancer. 2014 Dec 9. pii: S1558-7673(14)00263-8. doi: 10.1016/j.clgc.2014.12.003 |
| Cardiovascular mortality in patients with metastatic prostate cancer exposed to androgen deprivation therapy: a population-based study. |
| Gandaglia G1, Sun M2, Popa I3, Schiffmann J4, Trudeau V5, Shariat SF6, Trinh QD7, Graefen M8, Widmer H9, Saad F10, Briganti A11, Montorsi F12, Karakiewicz PI13 |
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Abstract INTRODUCTION: The aim of our study was to reexamine the prevalence of baseline cardiovascular (CV) morbidity and the rates of CV mortality in a contemporary cohort of patients with prostate cancer (PCa) exposed to androgen deprivation therapy (ADT). MATERIALS AND METHODS: Records of patients aged 65 years and older with metastatic PCa who received ADT were abstracted from the Surveillance, Epidemiology, and End Results-Medicare database between 1991 and 2009. The primary end points comprised 5-year CV mortality rates. Survival rates were stratified according to age and Charlson comorbidity index (CCI). Competing-risks Poisson regression methodologies were performed. RESULTS: Overall, 9596 patients with metastatic PCa treated with ADT were identified. At baseline, 3049 patients (31.8%) had preexisting CV disease. The 5-year CV mortality rates were 9.8% and 14.8% in the overall population and in patients with preexisting CV disease, respectively. The 5-year CV mortality rates increased with advanced age and higher CCI score. In multivariate competing-risks regression analyses, age, year of diagnosis, CV comorbidities, CCI, and marital status represented independent predictors of CV mortality, after accounting for the risk of dying from other causes (all P ≤ .04). Of those, preexisting CV disease contributed to the highest risk of CV mortality. Our study is limited by its retrospective nature. CONCLUSION: CV mortality represents a common event in patients with metastatic PCa treated with ADT. Preexisting CV disease represented the strongest risk factor. |
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Copyright © 2015 Elsevier Inc. All rights reserved. |
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KEYWORDS: Baseline comorbidities, Cardiovascular diseases, Competing-risks, Risk factors, Surveillance Epidemiology and End Results-Medicare database |
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Publikations ID: 25547676 Quelle: öffnen |
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