There are limited data on the physical effects of androgen deprivation therapy (ADT) for prostate cancer (PC), and on the relationships of such measures of adiposity and strength to cardiovascular outcomes.
The primary objective of this study was to evaluate the relationships of measures of adiposity and strength to cardiovascular outcomes (cardiovascular death, myocardial infarction, stroke, heart failure, arterial revascularization, peripheral arterial disease, and venous thromboembolism) in patients with PC. A secondary objective was to characterize the relationships between ADT use and 12-month changes in these physical measures.
This international, prospective cohort study included 3,967 patients with PC diagnosed in the prior 12 months or being treated with ADT for the first time. Median follow-up duration was 2.3 years.
Participants' mean age was 68.5 years, and 1,731 (43.6%) were exposed to ADT. ADT was associated with a 1.6% increase in weight, a 2.2% increase in waist circumference, a 1.6% increase in hip circumference, a 0.1% increase in waist-to-hip ratio, a 27.4% reduction in handgrip strength, and a 0.1% decrease in gait speed. High waist circumference and low handgrip strength were associated with adverse cardiovascular outcomes. Adjusting for age, education, race, tobacco and alcohol use, physical activity, cardiovascular disease, glomerular filtration rate, and ADT use, waist circumference above the highest quartile (110 cm) and handgrip strength below the lowest quartile (29.5 kg) were associated with higher likelihoods of a future cardiovascular event, with respective HRs of 1.40 (95% CI: 1.03-1.90; P = 0.029) and 1.59 (95% CI: 1.14-2.22; P = 0.006).
ADT was associated with increased adiposity and reduced strength over 12-month follow-up. High waist circumference and low baseline strength were associated with future adverse cardiovascular outcomes.
JACC. CardioOncology. 2024 Sep 03*** epublish ***
Darryl P Leong, Vincent Fradet, Tamim Niazi, Joseph B Selvanayagam, Robert Sabbagh, Celestia S Higano, Steven Agapay, Sumathy Rangarajan, Rajibul Mian, Carlos A K Nakashima, Negareh Mousavi, Ian Brown, Felipe H Valle, Luke T Lavallée, Bobby Shayegan, Kelvin K H Ng, Darin D Gopaul, Germano D Cavalli, Sonia Saavedra, Jose P Lopez-Lopez, Cristiano Freitas de Souza, Emmanuelle Duceppe, Lívia F Avezum Oliveira, Avirup Guha, Juan Esteban Gomez-Mesa, Luis Eduardo Silva Móz, Philippe D Violette, Álvaro Avezum, Gustavo B F Oliveira, Ariel G Kann, Edilson Walter, Cesar O L Dusilek, Nicolas Villareal Trujillo, Patricia Beato, Ludhmila A Hajjar, Patrick P W Luke, Eduardo Schlabendorff, David Sarid, Jehonathan Pinthus
Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Centre de Recherche du CHU de Québec, Université Laval, Quebec City, Quebec, Canada., Jewish General Hospital, Montreal, Quebec, Canada., Southern Area Local Health Network and Flinders University of South Australia, Adelaide, Australia., Faculty of Medicine, University of Sherbrooke, Montreal, Quebec, Canada., University of British Columbia and Madrona Oncology, Seattle, Washington, USA., Faculdades Pequeno Príncipe, Sociedade Hospitalar Angelina Caron, Araçatuba, Brazil., McGill University Health Centre, Montreal, Quebec, Canada., Division of Urology, Niagara Health System, St. Catharines, Ontario, Canada., Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Division of Urology, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada., Division of Urology, Department of Surgery, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada., Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Grand River Regional Cancer Centre, Kitchener, Ontario, Canada., Faculty of Medicine, University of La Frontera, Temuco, Chile., Masira Research Institute, Universidad de Santander, Bucaramanga, Colombia., Núcleo de Pesquisa Clínica - Rede São Camilo and Instituto Brasileiro de Controle do Cancer, São Paolo, Brazil., Department of Medicine, Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada., Centro de Pesquisa Clínica do HC-UFTM, Uberaba, Brazil., Augusta University, Augusta, Georgia, USA., Department of Health Sciences and Fundacíon Valle del Lili, Universidad Icesi, Cali, Colombia., Clinical Oncology Department, Santa Casa de São Paolo Hospital, São Paolo, Brazil., Woodstock Hospital, McMaster University, Woodstock, Ontario, Canada., International Research Center, Hospital Alemão Oswaldo Cruz, São Paolo, Brazil., Centro de Oncologia do Hospital de Clínicas Ijuí, Ijuí, Brazil., Hospital Rocio, Curitiba, Brazil., FOSCAL Internacional Clinic, Floridablanca, Colombia., Centro de Pesquisas Clínicas da Fundação Doutor Amaral Carvalho, São Paolo, Brazil., Faculdade de Medicina da Universidade de São Paolo, São Paolo, Brazil., Department of Surgery, London Health Science Centre, London, Ontario, Canada., Mãe de Deus Hospital, Porto Alegre, Brazil., Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel., Department of Surgery, McMaster University, Hamilton, Ontario, Canada.