Urology Medical News about Androgen deprivation therapy, Diabetes, Cardiovascular, Acute myocardial infarction

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Impact of androgen deprivation therapy on cardiovascular disease and diabetes
Journal of Clinical Oncology, 07/29/09

Alibhai SMH et al. - Continuous androgen deprivation therapy (ADT) use for at least 6 months in older men is associated with an increased risk of diabetes and fragility fracture but not acute myocardial infarction (AMI) or sudden cardiac death.

Methods

Study aims to investigate the association if any between ADT and increased risk of diabetes, acute myocardial infarction (AMI) and cardiovascular mortality
Using databases in Ontario, Canada, men age ≥66 yrs with PCa given continuous ADT for at least 6 mo or who underwent bilateral orchiectomy (n=19,079)
These pts were matched with men with PCa who had never received ADT
Treated and untreated groups were matched 1:1 on:
- age, prior cancer treatment, and year of diagnosis and
- propensity-matched on comorbidities, medications, CV risk factors, prior fractures, and socioeconomic variables
Primary outcomes: development of AMI, sudden cardiac death, and diabetes
Fragility fracture was also examined

Results

The cohort was observed for a mean of 6.47 yrs
In time-to-event analyses, ADT use was associated with an increased risk of diabetes and fragility fracture, but not with AMI or sudden cardiac death
Increasing duration of ADT was associated with an excess risk of fragility fractures and diabetes but not cardiac outcomes

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