Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer

Background. The association between patient demographics and CV events after ADT using real-world data was evaluated. In addition to encompassing >30 times more patients than all previous MACE studies, this is the first study, to the best of our knowledge, to include a comprehensive listing of many demographic factors from one large, recent US dataset over a long period of time. Materials and Methods. The retrospective analysis of data in the Decision Resources Group (now Clarivate) Real World Evidence repository, representing >300M US patients from 1991 to 2020 across all US regions, was performed. Patients with PCa receiving ≥1 ADT injection were included. MACE risk after ADT initiation was evaluated for demographic and potential PCa related risk factors. Kaplan–Meier survival curves were constructed, and Cox regression was used to evaluate the association between MACE risk and demographic/PCa-related risk factors. Results. Overall, MACE risk was slightly lower in the first year after ADT initiation (3.9%) vs. years 2–4 (∼5.2%). In a multivariate Cox model, MACE risk after ADT initiation was significantly higher for older vs. younger patients (adjusted HR per increasing year = 1.08, 95% CI: 1.07–1.09), men with a history of MACE vs. without (HR = 2.22, 95% CI: 1.72–2.88), men with very low BMI vs. normal or high BMI (HR for decreasing BMI per kg/m2 = 1.02, 95% CI: 1.01–1.03), White vs. Black patients (HR = 1.30, 95% CI: 1.08–1.55), and patients who did not use statins vs. those who did (HR = 1.13, 95% CI: 1.00–1.27). Of the PCa-related risk factors, MACE risk after ADT initiation was significantly higher for oncology vs. urology treatment setting (HR = 2.47, 95% CI: 2.12–2.88), patients with baseline metastasis vs. those without (HR = 2.30, 95% CI: 1.72–3.07), and patients treated with antagonists vs. agonists (HR = 1.62, 95% CI: 1.25–2.10). Conclusions. Demographic factors are important contributors to increased MACE risk for men with PCa on ADT. Clinicians should monitor risk factors and modify if possible.

Christopher J. D. Wallis,¹ Kevin C. Chen,² Stuart Atkinson,³ and Deborah M. Boldt-Houle³

Division of Urology, Department of Surgery, University of Toronto, 60 Murray Street, Kofer Ctr, 6th Floor, Toronto, Ontario M5G3L9, Canada
Analytics and Information, Xelay Acumen Group, Inc., 181 2nd Ave, Suite 488, San Mateo, California 94401, USA
Medical Affairs, Tolmar Inc., 485 Half Day Road, Suite 400, Buffalo Grove, IL 60089, USA

Source: Wallis CJD., Chen KC., Atkinson S. et al. Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer. Wiley Advances in Urology Volume 2024, Article ID 2988289, 12 pages. https://doi.org/10.1155/2024/298828.

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