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  • Hedlund, Pe rOlovKarolinska University Hospital Solna (author)

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

  • Article/chapterEnglish2011

Publisher, publication year, extent ...

  • 2011-05-31
  • London :Informa Healthcare,2011
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-71771
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-71771URI
  • https://doi.org/10.3109/00365599.2011.585820DOI
  • https://gup.ub.gu.se/publication/142486URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:123403181URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-49219URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Ferring AB, Malmo, Sweden||Ferring Laegemidler A/S Copenhagen, Denmark||Pharmacia AB, Uppsala, Sweden||Schering-Plough AB, Stockholm, Sweden||
  • 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 and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Johansson, RobertUmeå universitet,Onkologi(Swepub:umu)rojo0001 (author)
  • Damber, Jan-Erik,1949Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrens University Hospital(Swepub:gu)xdamja (author)
  • Hagerman, IngerKarolinska Institutet,Karolinska University Hospital Huddinge (author)
  • Henriksson, PeterKarolinska Institutet,Danderyd Hospital (author)
  • Iversen, PeterRigshosp, Copenhagen (author)
  • Klarskov, PeterHerlev University Hospital (author)
  • Mogensen, PeterFrederiksberg University Hospital (author)
  • Rasmussen, FinnHerlev University Hospital (author)
  • Varenhorst, EberhardÖstergötlands Läns Landsting,Linköpings universitet,Urologi,Hälsouniversitetet,Urologiska kliniken i Östergötland(Swepub:liu)ebeva05 (author)
  • Hedlund, Per Olov (author)
  • Hedelin, HansGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology(Swepub:gu)xhedeh (author)
  • Karolinska University Hospital SolnaOnkologi (creator_code:org_t)

Related titles

  • In:Scandinavian Journal of Urology and NephrologyLondon : Informa Healthcare45:5, s. 346-3530036-55991651-2065

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