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.
Nuver
J
J
Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Smit
A J
AJ
Sleijfer
D Th
DT
van Gessel
A I
AI
van Roon
A M
AM
van der Meer
J
J
van den Berg
M P
MP
Burgerhof
J G M
JG
Hoekstra
H J
HJ
Sluiter
W J
WJ
Gietema
J A
JA
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