Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer
Background. The association between patient demographics and CV events after ADT using real-world data was evaluated. In addition to encompassing >30 times more patients than all previous MACE studies, this is the first study, to the best of our knowledge, to include a comprehensive listing of ma...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
|
| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2024/2988289 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850166217021587456 |
|---|---|
| author | Christopher J. D. Wallis Kevin C. Chen Stuart Atkinson Deborah M. Boldt-Houle |
| author_facet | Christopher J. D. Wallis Kevin C. Chen Stuart Atkinson Deborah M. Boldt-Houle |
| author_sort | Christopher J. D. Wallis |
| collection | DOAJ |
| description | Background. The association between patient demographics and CV events after ADT using real-world data was evaluated. In addition to encompassing >30 times more patients than all previous MACE studies, this is the first study, to the best of our knowledge, to include a comprehensive listing of many demographic factors from one large, recent US dataset over a long period of time. Materials and Methods. The retrospective analysis of data in the Decision Resources Group (now Clarivate) Real World Evidence repository, representing >300M US patients from 1991 to 2020 across all US regions, was performed. Patients with PCa receiving ≥1 ADT injection were included. MACE risk after ADT initiation was evaluated for demographic and potential PCa-related risk factors. Kaplan–Meier survival curves were constructed, and Cox regression was used to evaluate the association between MACE risk and demographic/PCa-related risk factors. Results. Overall, MACE risk was slightly lower in the first year after ADT initiation (3.9%) vs. years 2–4 (∼5.2%). In a multivariate Cox model, MACE risk after ADT initiation was significantly higher for older vs. younger patients (adjusted HR per increasing year = 1.08, 95% CI: 1.07–1.09), men with a history of MACE vs. without (HR = 2.22, 95% CI: 1.72–2.88), men with very low BMI vs. normal or high BMI (HR for decreasing BMI per kg/m2 = 1.02, 95% CI: 1.01–1.03), White vs. Black patients (HR = 1.30, 95% CI: 1.08–1.55), and patients who did not use statins vs. those who did (HR = 1.13, 95% CI: 1.00–1.27). Of the PCa-related risk factors, MACE risk after ADT initiation was significantly higher for oncology vs. urology treatment setting (HR = 2.47, 95% CI: 2.12–2.88), patients with baseline metastasis vs. those without (HR = 2.30, 95% CI: 1.72–3.07), and patients treated with antagonists vs. agonists (HR = 1.62, 95% CI: 1.25–2.10). Conclusions. Demographic factors are important contributors to increased MACE risk for men with PCa on ADT. Clinicians should monitor risk factors and modify if possible. |
| format | Article |
| id | doaj-art-e08e34842a884eb59eec0908b94a3ce3 |
| institution | OA Journals |
| issn | 1687-6377 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Urology |
| spelling | doaj-art-e08e34842a884eb59eec0908b94a3ce32025-08-20T02:21:30ZengWileyAdvances in Urology1687-63772024-01-01202410.1155/2024/2988289Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate CancerChristopher J. D. Wallis0Kevin C. Chen1Stuart Atkinson2Deborah M. Boldt-Houle3Division of UrologyAnalytics and InformationMedical AffairsMedical AffairsBackground. The association between patient demographics and CV events after ADT using real-world data was evaluated. In addition to encompassing >30 times more patients than all previous MACE studies, this is the first study, to the best of our knowledge, to include a comprehensive listing of many demographic factors from one large, recent US dataset over a long period of time. Materials and Methods. The retrospective analysis of data in the Decision Resources Group (now Clarivate) Real World Evidence repository, representing >300M US patients from 1991 to 2020 across all US regions, was performed. Patients with PCa receiving ≥1 ADT injection were included. MACE risk after ADT initiation was evaluated for demographic and potential PCa-related risk factors. Kaplan–Meier survival curves were constructed, and Cox regression was used to evaluate the association between MACE risk and demographic/PCa-related risk factors. Results. Overall, MACE risk was slightly lower in the first year after ADT initiation (3.9%) vs. years 2–4 (∼5.2%). In a multivariate Cox model, MACE risk after ADT initiation was significantly higher for older vs. younger patients (adjusted HR per increasing year = 1.08, 95% CI: 1.07–1.09), men with a history of MACE vs. without (HR = 2.22, 95% CI: 1.72–2.88), men with very low BMI vs. normal or high BMI (HR for decreasing BMI per kg/m2 = 1.02, 95% CI: 1.01–1.03), White vs. Black patients (HR = 1.30, 95% CI: 1.08–1.55), and patients who did not use statins vs. those who did (HR = 1.13, 95% CI: 1.00–1.27). Of the PCa-related risk factors, MACE risk after ADT initiation was significantly higher for oncology vs. urology treatment setting (HR = 2.47, 95% CI: 2.12–2.88), patients with baseline metastasis vs. those without (HR = 2.30, 95% CI: 1.72–3.07), and patients treated with antagonists vs. agonists (HR = 1.62, 95% CI: 1.25–2.10). Conclusions. Demographic factors are important contributors to increased MACE risk for men with PCa on ADT. Clinicians should monitor risk factors and modify if possible.http://dx.doi.org/10.1155/2024/2988289 |
| spellingShingle | Christopher J. D. Wallis Kevin C. Chen Stuart Atkinson Deborah M. Boldt-Houle Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer Advances in Urology |
| title | Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer |
| title_full | Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer |
| title_fullStr | Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer |
| title_full_unstemmed | Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer |
| title_short | Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer |
| title_sort | patient demographics and major adverse cardiovascular events after androgen deprivation therapy for prostate cancer |
| url | http://dx.doi.org/10.1155/2024/2988289 |
| work_keys_str_mv | AT christopherjdwallis patientdemographicsandmajoradversecardiovasculareventsafterandrogendeprivationtherapyforprostatecancer AT kevincchen patientdemographicsandmajoradversecardiovasculareventsafterandrogendeprivationtherapyforprostatecancer AT stuartatkinson patientdemographicsandmajoradversecardiovasculareventsafterandrogendeprivationtherapyforprostatecancer AT deborahmboldthoule patientdemographicsandmajoradversecardiovasculareventsafterandrogendeprivationtherapyforprostatecancer |