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Significance of pre...
Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer: Evaluation of cardiovascular events in a randomized trial
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- Hedlund, Pe rOlov (author)
- Karolinska University Hospital Solna
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- Johansson, Robert (author)
- Umeå universitet,Onkologi
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- Damber, Jan-Erik, 1949 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrens University Hospital
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- Hagerman, Inger (author)
- Karolinska Institutet,Karolinska University Hospital Huddinge
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- Henriksson, Peter (author)
- Karolinska Institutet,Danderyd Hospital
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- Iversen, Peter (author)
- Rigshosp, Copenhagen
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- Klarskov, Peter (author)
- Herlev University Hospital
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- Mogensen, Peter (author)
- Frederiksberg University Hospital
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- Rasmussen, Finn (author)
- Herlev University Hospital
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- Varenhorst, Eberhard (author)
- Östergötlands Läns Landsting,Linköpings universitet,Urologi,Hälsouniversitetet,Urologiska kliniken i Östergötland
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Hedlund, Per Olov (author)
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- Hedelin, Hans (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology
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(creator_code:org_t)
- 2011-05-31
- 2011
- English.
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In: Scandinavian Journal of Urology and Nephrology. - London : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:5, s. 346-353
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Abstract
Subject headings
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- Objective. This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin (R)) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular disease. Material and methods. Nine-hundred and fifteen patients with T0-4, Nx, M1, G1-3, hormone- naive prostate cancer were randomized to treatment with PEP 240 mg i.m. twice a month for 2 months and thereafter monthly, or to flutamide (Eulexin (R)) 250 mg per os three times daily in combination with either triptorelin (Decapeptyl (R)) 3.75 mg i.m. per month or on an optional basis with bilateral orchidectomy. Pretreatment cardiovascular morbidity was recorded and cardiovascular events during treatment were assessed by an experienced cardiologist. A multivariate analysis was done using logistic regression. Results. There was a significant increase in cardiovascular events during treatment with PEP in patients with previous ischaemic heart disease (p = 0.008), ischaemic cerebral disease (p = 0.002), intermittent claudication (p = 0.031) and especially when the whole group of patients with pretreatment cardiovascular diseases was analysed together (p andlt; 0.001). In this group 33% of the patients had a cardiovascular event during PEP treatment. In the multivariate analysis PEP stood out as the most important risk factor for cardiac complications (p = 0.029). Even in the CAD group there was a significant increase in cardiovascular events in the group with all previous cardiovascular diseases taken together (p = 0.036). Conclusions. Patients with previous cardiovascular disease are at considerable risk of cardiovascular events during treatment with high-dose PEP and even during CAD therapy. Patients without pretreatment cardiovascular morbidity have a moderate cardiovascular risk during PEP treatment and could be considered for this treatment if the advantages of this therapy, e. g. avoidance of osteopenia and hot flushes and the low price, are given priority.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- cardiovascular events
- cardiovascular risk factors
- combined androgen deprivation
- parenteral oestrogen therapy
- prostate cancer
- randomized multicentre trial
- skeletal metastases
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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Hedlund, Pe rOlo ...
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Johansson, Rober ...
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Damber, Jan-Erik ...
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Hagerman, Inger
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Henriksson, Pete ...
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Iversen, Peter
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Klarskov, Peter
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Mogensen, Peter
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Rasmussen, Finn
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Varenhorst, Eber ...
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Hedlund, Per Olo ...
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Hedelin, Hans
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
- Articles in the publication
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Scandinavian Jou ...
- By the university
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Linköping University
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University of Gothenburg
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Karolinska Institutet
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Umeå University