title: Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in Chinese men with prostate cancer.
abstract: We investigated the cardiovascular thrombotic risk after surgical castration (SC) versus gonadotropin-releasing hormone agonists (GnRHa) in Chinese men with prostate cancer. All Chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan-Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 Chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group (75.3 ± 7.5 years) was significantly higher than the GnRHa group (71.8 ± 8.3 years) (P < 0.001). There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan-Meier analysis (P = 0.014). Upon multivariate Cox regression analysis, age (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04-1.11, P< 0.001), hyperlipidemia (HR 2.455, 95% CI 1.53-3.93, P< 0.001), and SC (HR 1.648, 95% CI 1.05-2.59, P= 0.031) were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.
authors.forename: Jeremy Yc
authors.initials: JY
authors.lastname: Teoh
authors.forename: Samson Ys
authors.initials: SY
authors.lastname: Chan
authors.forename: Peter Kf
authors.initials: PK
authors.lastname: Chiu
authors.forename: Darren Mc
authors.initials: DM
authors.lastname: Poon
authors.forename: Ho-Yuen
authors.initials: HY
authors.lastname: Cheung
authors.forename: Simon Sm
authors.initials: SS
authors.lastname: Hou
authors.affiliation: Department of Surgery, Division of Urology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors.forename: Chi-Fai
authors.initials: CF
authors.lastname: Ng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use; D044466:Asian People / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects* / Q000819:agonists*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D009919:Orchiectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000628:therapy*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone