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

  • 1Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. js315@hallym.or.kr
  • 2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Occupational and Environmental Medicine, Hallym University College of Medicine, Anyang, Korea.


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.
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).
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.
Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.


Antineoplastic Agents; Prostatic Neoplasm; Adverse Effects; Cardiovascular Diseases

MeSH Terms

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