Androgen-deprivation therapy (ADT) is a mainstay of treatment for prostate cancer but there is concern about the potential for cardiac toxicity. New insights are provided in a study of 5,077 men with cT1c-T3N0M0 prostate cancer published in BJU International (online, 29 October 2014)
In this cohort, cardiac-specific mortality at five years did not differ according to receipt or not of neoadjuvant ADT among men free of heart disease, even if they had cardiovascular risk factors. But among men with heart failure or a prior myocardial infarction, ADT was associated with a 5% absolute increase in cardiac mortality at five years versus no ADT.
“Administering ADT to 20 men in this potentially vulnerable subgroup could result in one cardiac death,” David Ziehr of Harvard Medical School, Boston, and colleagues estimate.