TY - JOUR
T1 - Risk of cardiovascular events in men treated for prostate cancer compared with prostate cancer-free men
AU - Moustsen, Ida Rask
AU - Larsen, Signe Benzon
AU - Duun-Henriksen, Anne Katrine
AU - Tjønneland, Anne
AU - Kjær, Susanne K
AU - Brasso, Klaus
AU - Johansen, Christoffer
AU - Dalton, Susanne Oksbjerg
PY - 2019
Y1 - 2019
N2 - BACKGROUND: The effect of lifestyle, anthropometry and cardiovascular risk factors on cardiovascular disease in men with prostate cancer (PCa) remains unclear.METHODS: Using a population-based cohort of 25,436 Danish, cancer-free men aged 50-64 years, we obtained information on self-reported pre-cancer lifestyle, objectively measured anthropometry and cardiovascular risk factors, and linked them to national health registers for information on major cardiovascular outcomes. We assessed hazard ratios (HRs) of incident acute myocardial infarction (MI), ischaemic stroke (IS) and heart failure (HF) among 1546 men diagnosed with PCa treated with first-line active surveillance, watchful waiting, intended curative or palliative treatment compared with PCa-free men during 18 years of follow-up.RESULTS: Men who received first-line palliative treatment had higher rates of IS and HF with adjusted HRs of 2.09 (95% CI 1.49-2.93) and 2.05 (95% CI 1.43-2.94), respectively, compared with PCa-free men. The risks were increased from start of treatment. We did not find the same relation for men in any other treatment group. No differences between men treated for PCa and cancer-free controls were observed for MI after adjustment for lifestyle, anthropometry, and cardiovascular risk factors.CONCLUSION: Pre-diagnosis lifestyle, anthropometry or cardiovascular risk factors did not explain the risk of IS and HF in PCa patients receiving palliative treatment. The results emphasise the need for balancing disease management and monitoring of cardiovascular health in this patient group.
AB - BACKGROUND: The effect of lifestyle, anthropometry and cardiovascular risk factors on cardiovascular disease in men with prostate cancer (PCa) remains unclear.METHODS: Using a population-based cohort of 25,436 Danish, cancer-free men aged 50-64 years, we obtained information on self-reported pre-cancer lifestyle, objectively measured anthropometry and cardiovascular risk factors, and linked them to national health registers for information on major cardiovascular outcomes. We assessed hazard ratios (HRs) of incident acute myocardial infarction (MI), ischaemic stroke (IS) and heart failure (HF) among 1546 men diagnosed with PCa treated with first-line active surveillance, watchful waiting, intended curative or palliative treatment compared with PCa-free men during 18 years of follow-up.RESULTS: Men who received first-line palliative treatment had higher rates of IS and HF with adjusted HRs of 2.09 (95% CI 1.49-2.93) and 2.05 (95% CI 1.43-2.94), respectively, compared with PCa-free men. The risks were increased from start of treatment. We did not find the same relation for men in any other treatment group. No differences between men treated for PCa and cancer-free controls were observed for MI after adjustment for lifestyle, anthropometry, and cardiovascular risk factors.CONCLUSION: Pre-diagnosis lifestyle, anthropometry or cardiovascular risk factors did not explain the risk of IS and HF in PCa patients receiving palliative treatment. The results emphasise the need for balancing disease management and monitoring of cardiovascular health in this patient group.
U2 - 10.1038/s41416-019-0468-8
DO - 10.1038/s41416-019-0468-8
M3 - Article
C2 - 31065112
SN - 0007-0920
VL - 120
SP - 1067
EP - 1074
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 11
ER -