title: [Cardiovascular risk of androgen deprivation therapy for treatment of hormone-dependent prostate cancer : Differences between GnRH antagonists and GnRH agonists].
abstract: BACKGROUND
  Several studies have indicated that reduction of testosterone levels in patients with prostate cancer undergoing androgen deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists can be associated with an increased risk of cardiovascular events. The GnRH antagonists have a different mode of action compared with GnRH agonists and may be preferred in ADT for patients with cardiovascular disease.
  
  
  OBJECTIVE
  This review article discusses potential mechanisms underlying the development of cardiovascular events associated with ADT when using GnRH agonists and explains the differences in mode of action between GnRH agonists and GnRH antagonists. Additionally, relevant studies are presented and practical recommendations for the clinical practice are provided.
  
  
  METHODS
  A literature search was performed. Full publications and abstracts published in the last 10 years up to September 2015 were considered to be eligible.
  
  
  RESULTS
  The GnRH antagonists were associated with a decreased risk of cardiovascular events compared with GnRH agonists in prostate cancer patients undergoing ADT and particularly in patients with cardiovascular risk factors or a history of cardiovascular disease. This decrease may be due to the different mode of action of GnRH antagonists compared with GnRH agonists.
  
  
  CONCLUSIONS
  Prostate cancer patients with either cardiovascular disease or an increased risk of experiencing a cardiovascular event undergoing ADT should be preferentially treated with GnRH antagonists.
authors.affiliation: Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland. Carsten.tschoepe@charite.de.|Berliner Zentrum für Regenerative Therapien (BCRT), Campus Virchow-Klinikum (CVK), Berlin, Deutschland. Carsten.tschoepe@charite.de.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Charité Berlin, Berlin, Deutschland. Carsten.tschoepe@charite.de.
authors.forename: C
authors.initials: C
authors.lastname: Tschöpe
authors.affiliation: Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Kherad
authors.affiliation: Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Spillmann
authors.affiliation: Kardiologie an der PAN-Klinik, Köln, Deutschland.
authors.forename: C A
authors.initials: CA
authors.lastname: Schneider
authors.affiliation: Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland.|Deutsches Herzzentrum, Berlin, Deutschland.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Charité Berlin, Berlin, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Pieske
authors.affiliation: Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Krackhardt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D019317:Evidence-Based Medicine; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone
keywords: Androgen deprivation therapy; Cardiovascular risk; GnRH agonist; GnRH antagonist; Prostatic neoplasms