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    Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/34639


    Title: Comparison of Surgical or Medical Castration-Related Cardiotoxicity in Patients with Prostate Cancer
    Authors: Kan, Wei-Chih
    Hsieh, Kun-Lin
    Chen, Yi-Chen
    Ho, Chung Han
    Hong, Chon-Seng
    Chiang, Chun-Yen
    Wu, Nan-Chun
    Chen, Michael
    Shih, Jhih-Yuan
    Chen, Zhih-Cherng
    Chang, Wei-Ting
    Contributors: Chi Mei Hospital
    Chung Hua University
    Chi Mei Hospital
    National Cheng Kung University
    Chi Mei Hospital
    Department of Pharmacy, Chia Nan University of Pharmacy & Science
    Chi Mei Hospital
    Chung Hua University
    Chi Mei Hospital
    Department of Health and Nutrition, Chia Nan University of Pharmacy & Science
    Southern Taiwan University of Science & Technology
    National Cheng Kung University
    Keywords: androgen-deprivation therapy
    hormone agonists
    serum testosterone
    risk
    men
    disease
    orchiectomy
    atherosclerosis
    suppression
    level
    Date: 2022
    Issue Date: 2023-12-11 14:02:01 (UTC+8)
    Publisher: LIPPINCOTT WILLIAMS & WILKINS
    Abstract: Purpose: Androgen deprivation therapy (ADT) includes bilateral orchiectomy or long-acting gonadotropin-releasing hormone (GnRH) agonists/antagonists. It remains controversial with respect to ADT associated cardiovascular outcomes. Hereby, we compared the risk of major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with prostate cancer receiving either surgical castration or GnRH therapies. Materials and Methods: Using the Taiwan Cancer Registry and Taiwan's National Health Insurance Research Database, we identified 8,413 patients receiving GnRH therapies compared with 694 receiving surgical castration from 2008 to 2017. The median followup duration was 3 years. Results: The crude incidences of 3-year mortality and MACCEs were 19.90% vs 26.51% and 8.23% vs 8.65% in patients receiving GnRH therapies or surgical castration, respectively. After adjusting for age, cancer stage and comorbidities, despite no significant differences in MACCEs between groups there was a slight increase in the incidence of acute myocardial infarction (AMI) in patients receiving surgical castration compared with those receiving GnRH therapies. The mortality adjusted hazard ratios of MACCEs and AMI among patients receiving surgical castration were 1.11- and 1.8-fold higher than those receiving GnRH therapies. Notably, in subgroup analysis regarding cancer stage, patients with cancer stage IV showed the most significantly increasing risk of AMI in those receiving surgical castration compared with GnRH therapies. Conclusions: Collectively, we indicated an increased risk of AMI in patients with prostate cancer, especially in patients receiving surgical castration rather than those receiving GnRH therapies. Our findings highlight concerns regarding the cardiac safety of surgical castration compared with GnRH therapies.
    Relation: JOURNAL OF UROLOGY, v.207, Issue 4, pp.841-850
    Appears in Collections:[Dept. of Pharmacy] Periodical Articles
    [Dept. of Health and Nutrition (including master's program)] Periodical Articles

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