Researchers conclude modest CVD risk should be considered in prescribing but is not contraindicated

-- Jeff Muise

Thursday, June 24, 2010 (Last Updated: 06/25/2010)

THURSDAY, June 24 (HealthDay News) -- Men with prostate cancer who receive endocrine treatment (ET) have a modest increase in risk for cardiovascular disease (CVD), suggesting that clinicians should consider CVD risk when prescribing this treatment, according to a study published online June 21 in the Journal of Clinical Oncology.

Mieke Van Hemelrijck, of King's College London, and colleagues assessed data on 76,600 prostate cancer patients from Sweden's National Prostate Cancer Registry. The researchers calculated standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for CVD outcomes among the patients.

During 1997 to 2007, 30,642 of the patients received primary ET, 26,432 received curative treatment, and 19,527 underwent surveillance. The researchers found that the SIRs for CVD were elevated in all three groups, but they were highest for those undergoing ET, independent of circulatory disease history. For men without circulatory disease history, the SIRs for myocardial infarction were 1.40 for those undergoing ET, 1.15 for men receiving curative treatment, and 1.20 for men receiving surveillance. Analysis of absolute risk differences (ARD) found that two to eight extra cases of CVD would occur per 1,000 person-years, while SMRs ranged from zero to three per 1,000 person-years.

"Increased relative risks of nonfatal and fatal CVD were found among all men with prostate cancer, especially those treated with ET. Because ET is currently the only effective treatment for metastatic disease and the ARDs were rather small, our findings indicate that CVD risk should be considered when prescribing ET but should not constitute a contraindication when the expected gain is tangible," the authors write.

One study author disclosed financial ties to Ferring Pharmaceuticals; another author disclosed ties to AstraZeneca.

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Specialties Hematology & Oncology
OBGYN & Women's Health
Internal Medicine
Family Practice

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