Microalbuminuria, decreased fibrinolysis, and inflammation as early signs of atherosclerosis in long-term survivors of disseminated testicular cancer.
Testicular cancer patients have an increased risk for coronary artery disease more than ten years after cisplatin-based chemotherapy. We investigated whether vascular changes, including endothelial dysfunction, are present earlier. Ninety chemotherapy-treated testicular cancer patients (median follow-up of seven years) were compared with 44 patients after orchidectomy only and 47 healthy men. Microalbuminuria was present in 10 (12%) chemotherapy patients, one stage I patient and none of the controls. Chemotherapy patients had higher levels of fibrinogen, C-reactive protein (hs-CRP), von Willebrand factor (vWF), plasminogen activator inhibitor (PAI-1), and tissue-type plasminogen activator (t-PA). Chemotherapy patients with elevated PAI-1 (25/90) showed clustering of cardiovascular risk factors resembling the metabolic syndrome. In conclusion, cured testicular cancer patients showed a high prevalence of microalbuminuria and increased plasma levels of endothelial and inflammatory marker proteins, which might progress to more severe endothelial dysfunction and overt atherosclerosis.
Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
J
J
Nuver
A J
AJ
Smit
D Th
DT
Sleijfer
A I
AI
van Gessel
A M
AM
van Roon
J
J
van der Meer
M P
MP
van den Berg
J G M
JG
Burgerhof
H J
HJ
Hoekstra
W J
WJ
Sluiter
J A
JA
Gietema
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000139:chemically induced*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001161:Arteriosclerosis / Q000139:chemically induced*; D001779:Blood Coagulation Factors / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002945:Cisplatin / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005342:Fibrinolysis / Q000187:drug effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery
D000970:Antineoplastic Agents; D001779:Blood Coagulation Factors; D002097:C-Reactive Protein; D002945:Cisplatin