title: The influence of cardiovascular morbidity on the prognosis in prostate cancer. Experience from a 12-year nationwide Danish population-based cohort study.
abstract: BACKGROUND
  To determine the impact of preexisting ischemic heart disease (IHD) and stroke on overall survival in prostate cancer patients.
  
  
  METHODS
  We conducted a cohort study of patients with incident prostate cancer registered in the Danish Cancer Registry from 1997 through 2008. We identified patients diagnosed with IHD or stroke prior to the date of prostate cancer diagnosis in the Danish National Patient Registry. We constructed Kaplan-Meier curves to analyze time to death and Cox regression was used to estimate hazard ratios (HRs) to compare mortality rates by preexisting IHD or stroke status, adjusting for age, stage, comorbidity, and calendar period.
  
  
  RESULTS
  Of 30,721 prostate cancer patients, 4,276 (14%) had preexisting IHD and 1,331 (4%) preexisting stroke. Crude 1- and 5-year survival rates were 85% and 44% in men without preexisting IHD or stroke, 81% and 36% in men with preexisting IHD, and 78% and 27% in men with preexisting stroke. Adjusted HRs were 1.05 (95% CI 1.00-1.10) for patients with IHD and 1.20 (95% CI 1.12-1.30) for patients with stroke compared with patients without preexisting IHD or stroke.
  
  
  CONCLUSIONS
  Preexisting IHD had minimal impact on mortality in prostate cancer patients, whereas overall mortality was 20% higher in prostate cancer patients with preexisting stroke compared to those without IHD or stroke. These results highlight the importance of differentiating between various comorbidities.
authors.affiliation: Department of Urology, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. christina.gade@ki.au.dk
authors.forename: Christina G
authors.initials: CG
authors.lastname: Jespersen
authors.forename: Mette
authors.initials: M
authors.lastname: Nørgaard
authors.forename: Truls E
authors.initials: TE
authors.lastname: Bjerklund Johansen
authors.forename: Mette
authors.initials: M
authors.lastname: Søgaard
authors.forename: Michael
authors.initials: M
authors.lastname: Borre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000401:mortality; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D016019:Survival Analysis