J Korean Med Sci.  2020 Feb;35(4):e47. 10.3346/jkms.2020.35.e47.

The Use of Gonadotropin-Releasing Hormone Agonist Does Not Affect the Development of Cardiovascular Disease in Prostate Cancer Patients: a Nationwide Population-Based Cohort Study

• Shim M
• Bang WJ
• Oh CY
• Lee YS
• Jeon SS
• Ahn H
• Ju YS
• Cho JS

• KMID: 2468523
• DOI: http://doi.org/10.3346/jkms.2020.35.e47

Abstract

BACKGROUND
The objective of this study was to investigate whether androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonist (GnRHa) in prostate cancer (Pca) patients is associated with cardiovascular disease in the cohort based from the entire Korean population.
METHODS
Using the Korean National Health Insurance database, we conducted an observational study of 579,377 men who sought treatment for Pca between January 1, 2012 and December 31, 2016. After excluding patients with previously diagnosed cardiovascular disease or who had undergone chemotherapy, we extracted the data from 2,053 patients who started GnRHa (GnRHa users) and 2,654 men who were newly diagnosed with Pca (GnRHa nonusers) between July 1, 2012, and December 31, 2012, with follow-up through December 31, 2016. The primary outcomes were cerebrovascular attack (CVA) and ischemic heart disease (IHD).
RESULTS
GnRHa users were older, were more likely to reside in rural areas, had lower socioeconomic status, and had more comorbidities than nonusers (all P < 0.050). Although GnRHa users had an increased incidence of CVA and IHD (P = 0.013 and 0.048, respectively) in univariate analysis, GnRHa use was not associated with the outcomes in multivariate analysis. Furthermore, the cumulative duration of ADT was not associated with the outcomes whereas the associations between age at diagnosis with all diseases were significant.
CONCLUSION
Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.

Keyword

Antineoplastic Agents; Prostatic Neoplasm; Adverse Effects; Cardiovascular Diseases

MeSH Terms

Antineoplastic Agents
Cardiovascular Diseases*
Cohort Studies*
Comorbidity
Diagnosis
Drug Therapy
Follow-Up Studies
Gonadotropin-Releasing Hormone*
Humans
Incidence
Male
Morinda
Multivariate Analysis
Myocardial Ischemia
National Health Programs
Observational Study
Passive Cutaneous Anaphylaxis
Prostate*
Prostatic Neoplasms*
Social Class
Antineoplastic Agents
Gonadotropin-Releasing Hormone