Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study
Abstract Background Androgen deprivation therapy (ADT) is the cornerstone treatment strategy for men diagnosed with high-risk prostate cancer (PC) but may increase risk for major adverse cardiovascular events (MACE). We examined whether men treated with ADT and radiation therapy (ADT + RT) developed...
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BMC
2025-02-01
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| Series: | Cardio-Oncology |
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| Online Access: | https://doi.org/10.1186/s40959-025-00312-x |
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| author | Alexander R. Lucas Dustin Bastiach Bassam Dahman Asit K. Paul Samina Hirani Vanessa B. Sheppard W. Gregory Hundley Bhaumik B. Patel Rhonda L. Bitting Michael G. Chang |
| author_facet | Alexander R. Lucas Dustin Bastiach Bassam Dahman Asit K. Paul Samina Hirani Vanessa B. Sheppard W. Gregory Hundley Bhaumik B. Patel Rhonda L. Bitting Michael G. Chang |
| author_sort | Alexander R. Lucas |
| collection | DOAJ |
| description | Abstract Background Androgen deprivation therapy (ADT) is the cornerstone treatment strategy for men diagnosed with high-risk prostate cancer (PC) but may increase risk for major adverse cardiovascular events (MACE). We examined whether men treated with ADT and radiation therapy (ADT + RT) developed MACE at a higher rate than men receiving RT alone. Secondly, we sought to determine if Black men receiving RT + ADT developed MACE at a higher rate than White men. Methods This retrospective cohort study examined time to diagnosis of MACE among Veterans with PC. We used a 1:1 propensity score matching process to determine whether treatment type (ADT + RT vs. RT alone), race (Black vs. White men) or having a previous diagnosis of a cardiometabolic disease (CMD) were associated with differences in the rate at which men develop MACE. Results Veterans with PC were White (68%) and Black (32%). At PC diagnosis, the mean age was 65.9 years. The majority had stage 2 disease (83.0%) classified as intermediate risk (43.1%). Treatment-matched models showed men receiving ADT + RT were less likely to develop MACE when they no pre-existing CMD. Men treated with ADT + RT or RT alone had significantly increased risks of MACE is they had pre-existing CMD. Black men had the same risk of MACE as non-Hispanic Whites. Conclusions Preexisting CMD and multimorbidity are significant risks for MACE among men treated for PC within the VA healthcare system whether treated with ADT + RT or with RT alone, highlighting the importance pretreatment optimization of comorbidities. |
| format | Article |
| id | doaj-art-df55923b4af3434880e56455fd48bc9c |
| institution | Kabale University |
| issn | 2057-3804 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardio-Oncology |
| spelling | doaj-art-df55923b4af3434880e56455fd48bc9c2025-02-09T12:56:36ZengBMCCardio-Oncology2057-38042025-02-0111111210.1186/s40959-025-00312-xMajor adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort studyAlexander R. Lucas0Dustin Bastiach1Bassam Dahman2Asit K. Paul3Samina Hirani4Vanessa B. Sheppard5W. Gregory Hundley6Bhaumik B. Patel7Rhonda L. Bitting8Michael G. Chang9Department of Social and Behavioral Sciences, Virginia Commonwealth University School of Public HealthDepartment of Biostatistics, Virginia Commonwealth University School of Public HealthDivision of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth UniversityDivision of Hematology and Oncology, Department of Medicine, Virginia Commonwealth UniversityDivision of Hematology and Oncology, Department of Medicine, Virginia Commonwealth UniversityDivision of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth UniversityDivision of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth UniversityDivision of Hematology and Oncology, Department of Medicine, Virginia Commonwealth UniversityDivision of Medical Oncology, Department of Medicine, Duke University and Durham VA Healthcare SystemDepartment of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University Health SystemAbstract Background Androgen deprivation therapy (ADT) is the cornerstone treatment strategy for men diagnosed with high-risk prostate cancer (PC) but may increase risk for major adverse cardiovascular events (MACE). We examined whether men treated with ADT and radiation therapy (ADT + RT) developed MACE at a higher rate than men receiving RT alone. Secondly, we sought to determine if Black men receiving RT + ADT developed MACE at a higher rate than White men. Methods This retrospective cohort study examined time to diagnosis of MACE among Veterans with PC. We used a 1:1 propensity score matching process to determine whether treatment type (ADT + RT vs. RT alone), race (Black vs. White men) or having a previous diagnosis of a cardiometabolic disease (CMD) were associated with differences in the rate at which men develop MACE. Results Veterans with PC were White (68%) and Black (32%). At PC diagnosis, the mean age was 65.9 years. The majority had stage 2 disease (83.0%) classified as intermediate risk (43.1%). Treatment-matched models showed men receiving ADT + RT were less likely to develop MACE when they no pre-existing CMD. Men treated with ADT + RT or RT alone had significantly increased risks of MACE is they had pre-existing CMD. Black men had the same risk of MACE as non-Hispanic Whites. Conclusions Preexisting CMD and multimorbidity are significant risks for MACE among men treated for PC within the VA healthcare system whether treated with ADT + RT or with RT alone, highlighting the importance pretreatment optimization of comorbidities.https://doi.org/10.1186/s40959-025-00312-xAndrogen deprivation therapyMajor adverse cardiovascular eventsCardiometabolic diseaseProstate cancerSurvivorshipVeterans |
| spellingShingle | Alexander R. Lucas Dustin Bastiach Bassam Dahman Asit K. Paul Samina Hirani Vanessa B. Sheppard W. Gregory Hundley Bhaumik B. Patel Rhonda L. Bitting Michael G. Chang Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study Cardio-Oncology Androgen deprivation therapy Major adverse cardiovascular events Cardiometabolic disease Prostate cancer Survivorship Veterans |
| title | Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study |
| title_full | Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study |
| title_fullStr | Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study |
| title_full_unstemmed | Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study |
| title_short | Major adverse cardiovascular events among Black and White Veterans receiving androgen deprivation therapy for prostate cancer: a retrospective cohort study |
| title_sort | major adverse cardiovascular events among black and white veterans receiving androgen deprivation therapy for prostate cancer a retrospective cohort study |
| topic | Androgen deprivation therapy Major adverse cardiovascular events Cardiometabolic disease Prostate cancer Survivorship Veterans |
| url | https://doi.org/10.1186/s40959-025-00312-x |
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