Hormone Therapy Usage Is Associated With Adverse Cardiovascular Events in Prostate Cancer Patients of the All of Us Research Program Cohort

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Hauptverfasser: Yuanchu J. Yang, Chenjie Zeng, Kerry R. Schaffer, Tam C. Tran, Peter J. Sauer, Lincoln A. Brown, Ben H. Park, Joshua C. Denny
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Veröffentlicht: Wiley 2025
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author Yuanchu J. Yang
Chenjie Zeng
Kerry R. Schaffer
Tam C. Tran
Peter J. Sauer
Lincoln A. Brown
Ben H. Park
Joshua C. Denny
author_facet Yuanchu J. Yang
Chenjie Zeng
Kerry R. Schaffer
Tam C. Tran
Peter J. Sauer
Lincoln A. Brown
Ben H. Park
Joshua C. Denny
Yuanchu J. Yang
Chenjie Zeng
Kerry R. Schaffer
Tam C. Tran
Peter J. Sauer
Lincoln A. Brown
Ben H. Park
Joshua C. Denny
collection Wiley Open Access
contents Hormone Therapy Usage Is Associated With Adverse Cardiovascular Events in Prostate Cancer Patients of the All of Us Research Program Cohort Yuanchu J. Yang Chenjie Zeng Kerry R. Schaffer Tam C. Tran Peter J. Sauer Lincoln A. Brown Ben H. Park Joshua C. Denny The Prostate ABSTRACTBackgroundHormone therapy (HT) has greatly improved overall survival for prostate cancer patients, but may also influence cardiovascular health in an already high‐risk population.MethodsThis retrospective cohort study examined participants in the All of Us Research Program with prostate cancer, had no prior history of adverse cardiovascular events, and were either treated or not treated with HT. HT was defined as GnRH agonists, GnRH antagonists, abiraterone, androgen antagonists, or androgen receptor pathway inhibitors. We defined adverse cardiovascular event as myocardial infarctions, heart failure, or strokes. Time to adverse cardiovascular event was defined using longitudinal electronic health record data. We evaluated whether HT use affected the risk of adverse cardiovascular events using a Cox regression model adjusted for established cardiovascular risk factors.ResultsThe final cohort included 5156 participants. After adjustment for cardiovascular risk covariates, HT treatment was associated with increased risk of adverse cardiovascular event (HR: 1.22; 95% CI: 1.01–1.48; p = 0.03). In participants with pre‐treatment dyslipidemia, HT usage was associated with increased risk of adverse cardiovascular events (HR: 1.52; 95% CI: 1.19–1.95; p < 0.001). In participants without pre‐treatment dyslipidemia, no association was found (HR: 0.96; 95% CI: 0.71–1.30; p = 0.81).ConclusionsOur results show that HT‐associated cardiovascular risk may be synergistically amplified by dyslipidemia. These results suggest that risk stratification by dyslipidemia status may improve cardiovascular outcomes for prostate cancer survivors. 10.1002/pros.24913 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1002/pros.24913
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id wiley_oa_10_1002_pros_24913
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
publishDate 2025
publisher Wiley
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spellingShingle Hormone Therapy Usage Is Associated With Adverse Cardiovascular Events in Prostate Cancer Patients of the All of Us Research Program Cohort
Yuanchu J. Yang
Chenjie Zeng
Kerry R. Schaffer
Tam C. Tran
Peter J. Sauer
Lincoln A. Brown
Ben H. Park
Joshua C. Denny
The Prostate
Hormone Therapy Usage Is Associated With Adverse Cardiovascular Events in Prostate Cancer Patients of the All of Us Research Program Cohort Yuanchu J. Yang Chenjie Zeng Kerry R. Schaffer Tam C. Tran Peter J. Sauer Lincoln A. Brown Ben H. Park Joshua C. Denny The Prostate ABSTRACTBackgroundHormone therapy (HT) has greatly improved overall survival for prostate cancer patients, but may also influence cardiovascular health in an already high‐risk population.MethodsThis retrospective cohort study examined participants in the All of Us Research Program with prostate cancer, had no prior history of adverse cardiovascular events, and were either treated or not treated with HT. HT was defined as GnRH agonists, GnRH antagonists, abiraterone, androgen antagonists, or androgen receptor pathway inhibitors. We defined adverse cardiovascular event as myocardial infarctions, heart failure, or strokes. Time to adverse cardiovascular event was defined using longitudinal electronic health record data. We evaluated whether HT use affected the risk of adverse cardiovascular events using a Cox regression model adjusted for established cardiovascular risk factors.ResultsThe final cohort included 5156 participants. After adjustment for cardiovascular risk covariates, HT treatment was associated with increased risk of adverse cardiovascular event (HR: 1.22; 95% CI: 1.01–1.48; p = 0.03). In participants with pre‐treatment dyslipidemia, HT usage was associated with increased risk of adverse cardiovascular events (HR: 1.52; 95% CI: 1.19–1.95; p < 0.001). In participants without pre‐treatment dyslipidemia, no association was found (HR: 0.96; 95% CI: 0.71–1.30; p = 0.81).ConclusionsOur results show that HT‐associated cardiovascular risk may be synergistically amplified by dyslipidemia. These results suggest that risk stratification by dyslipidemia status may improve cardiovascular outcomes for prostate cancer survivors. 10.1002/pros.24913 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Hormone Therapy Usage Is Associated With Adverse Cardiovascular Events in Prostate Cancer Patients of the All of Us Research Program Cohort
topic The Prostate
url https://onlinelibrary.wiley.com/doi/10.1002/pros.24913