Association between duration of gonadotrophin-releasing hormone agonist use and cardiovascular risks: A population-based competing-risk analysis Journal Article


Authors: Chan, J. S. K.; Tang, P.; Hui, J. M. H.; Lee, Y. H. A.; Dee, E. C.; Ng, K.; Liu, K.; Tse, G.; Ng, C. F.
Article Title: Association between duration of gonadotrophin-releasing hormone agonist use and cardiovascular risks: A population-based competing-risk analysis
Abstract: Background: Although androgen deprivation therapy has known cardiovascular risks, it is unclear if its duration is related to cardiovascular risks. This study thus aimed to investigate the associations between gonadotrophin-releasing hormone (GnRH) agonist use duration and cardiovascular risks. Methods: This retrospective cohort study included adult patients with prostate cancer receiving GnRH agonists in Hong Kong during 1999–2021. Patients who switched to GnRH antagonists, underwent bilateral orchidectomy, had <6 months of GnRH agonist, prior myocardial infarction (MI), or prior stroke was excluded. All patients were followed up until September 2021 for a composite endpoint of MI and stroke. Multivariable competing-risk regression using the Fine-Gray subdistribution model was used, with mortality from any cause as the competing event. Results: In total, 4038 patients were analyzed (median age 74.9 years old, interquartile range (IQR) 68.7–80.8 years old). Over a median follow-up of 4.1 years (IQR 2.1–7.5 years), longer GnRH agonists use was associated with higher risk of the endpoint (sub-hazard ratio per year 1.04 [1.01–1.06], p = 0.001), with those using GnRH agonists for ≥2 years having an estimated 23% increase in the sub-hazard of the endpoint (sub-hazard ratio 1.23 [1.04–1.46], p = 0.017). Conclusion: Longer GnRH agonist use may be associated with greater cardiovascular risks. © 2022 The Authors. The Prostate published by Wiley Periodicals LLC.
Keywords: adult; aged; aged, 80 and over; retrospective studies; androgen; retrospective study; gonadorelin; risk assessment; prostate cancer; prostatic neoplasms; stroke; prostate tumor; androgen antagonists; antiandrogen; androgen deprivation therapy; gonadotropin-releasing hormone; androgens; cerebrovascular accident; cohort; very elderly; humans; human; male; cardio-oncology
Journal Title: Prostate
Volume: 82
Issue: 15
ISSN: 0270-4137
Publisher: John Wiley & Sons  
Date Published: 2022-11-01
Start Page: 1477
End Page: 1480
Language: English
DOI: 10.1002/pros.24423
PUBMED: 35915869
PROVIDER: scopus
PMCID: PMC9804360
DOI/URL:
Notes: Article -- Export Date: 3 October 2022 -- Source: Scopus
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  1. Edward Christopher Dee
    261 Dee