Long-term prognostic impact of cardiovascular comorbidities in patients with prostate cancer receiving androgen deprivation therapy: A population-based competing risk analysis.
Journal article
Chan, J., Lee, Yan Hiu Athena, Hui, Jeremy Man Ho, Liu, Kang, Dee, Edward Christopher, Ng, Kenrick, Liu, T., Tse, Gary and Ng, Chi Fai 2023. Long-term prognostic impact of cardiovascular comorbidities in patients with prostate cancer receiving androgen deprivation therapy: A population-based competing risk analysis. International Journal of Cancer. https://doi.org/10.1002/ijc.34557
| Authors | Chan, J., Lee, Yan Hiu Athena, Hui, Jeremy Man Ho, Liu, Kang, Dee, Edward Christopher, Ng, Kenrick, Liu, T., Tse, Gary and Ng, Chi Fai |
|---|---|
| Abstract | Our study investigated how adverse cardiovascular outcomes are impacted by cardiovascular comorbidities in patients with prostate cancer treated by androgen deprivation therapy (ADT). Using prospective, population-based data, all Hong Kong patients with prostate cancer who received ADT during 1 January 1993 to 3 March 2021 were identified and followed up for the endpoint of cardiovascular hospitalization/mortality until 31 September 2021, whichever earlier. Multivariable competing risk regression was used to compare the endpoint's cumulative incidence between different combinations of major cardiovascular comorbidities (heart failure [HF], myocardial infarction [MI], stroke and/or arrhythmia), with noncardiovascular death as competing event. Altogether, 13 537 patients were included (median age 75.9 [interquartile range 70.0-81.5] years old; median follow-up 3.3 [1.5-6.7] years). Compared to those with none of prior HF/MI/stroke/arrhythmia, the incidence of the endpoint was not different in those with only stroke (subhazard ratio [SHR] 1.06 [95% confidence interval (CI): 0.92-1.23], P = .391), but was higher in those with only HF (SHR 1.67 [1.37-2.02], P < .001), arrhythmia (SHR 1.63 [1.35-1.98], P < .001) or MI (SHR 1.43 [1.14-1.79], P = .002). Those with ≥2 of HF/MI/stroke/arrhythmia had the highest incidence of the endpoint (SHR 1.94 [1.62-2.33], P < .001), among whom different major cardiovascular comorbidities had similar prognostic impacts, with the number of comorbidities present being significantly prognostic instead. In conclusion, in patients with prostate cancer receiving ADT, the sole presence of HF, MI or arrhythmia, but not stroke, may be associated with elevated cardiovascular risks. In those with ≥2 of HF/MI/stroke/arrhythmia, the number of major cardiovascular comorbidities may be prognostically more important than the type of comorbidities. [Abstract copyright: © 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.] |
| Keywords | Cardio-oncology; Androgen deprivation therapy; Comorbidity; Mortality; Hospitalization; Prostate cancer |
| Year | 2023 |
| Journal | International Journal of Cancer |
| Publisher | Wiley |
| ISSN | 1097-0215 |
| Digital Object Identifier (DOI) | https://doi.org/10.1002/ijc.34557 |
| Official URL | https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.34557 |
| Funder | NCI NIH HHS |
| Hong Kong Metropolitan University. Grant Number: RIF/2022/2.2 | |
| Research Matching Grant. Grant Number: 8601454 | |
| Tianjin Key Medical Discipline (Specialty) Construction Project. Grant Number: TJYXZDXK-029A | |
| Cancer Center Support Grant from the National Cancer Institute. Grant Number: P30 CA008748 | |
| Publication dates | |
| Online | 14 May 2023 |
| Publication process dates | |
| Accepted | 25 Apr 2023 |
| Deposited | 31 May 2023 |
| Publisher's version | License |
| Output status | Published |
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https://repository.canterbury.ac.uk/item/94v63/long-term-prognostic-impact-of-cardiovascular-comorbidities-in-patients-with-prostate-cancer-receiving-androgen-deprivation-therapy-a-population-based-competing-risk-analysis
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