Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan.
J Clin Pharmacol. 2019 Mar;59(3):335-343. doi: 10.1002/jcph.1332. Epub 2018 Nov 7.
The aim of this study was to investigate the relationship between androgen deprivation therapy and heart failure among prostate cancer patients. This cohort study used the data from the Taiwan Longitudinal Health Insurance Database 2005. In the full cohort study, we identified 1244 prostate cancer patients who had received androgen deprivation therapy as the study cohort and 1806 prostate cancer patients who did not receive androgen deprivation therapy as the comparison cohort. To eliminate potential bias, we performed a propensity score-matched cohort study. Each prostate cancer patient was tracked for 1 year from the index date to ascertain whether they were subsequently diagnosed with heart failure. In the full cohort study, incidence rates of heart failure per 100 person-years within the 1-year follow-up period were 4.00 (95%CI, 2.95-5.30) and 1.89 (95%CI, 1.30-2.66) for androgen deprivation therapy users and nonusers, respectively. In addition, the multivariable Cox regression indicated that the hazard ratio (HR) of heart failure among androgen deprivation therapy users was 1.72 (95%CI, 1.08-2.73) compared with those androgen deprivation therapy nonusers. In the propensity score-matched cohort study, the adjusted HR for heart failure among androgen deprivation therapy users was 1.92 (95%CI, 1.15-3.18) compared with propensity score-matched nonusers. In conclusion, this study found that androgen deprivation therapy users had a higher risk of heart failure than nonusers among prostate cancer patients in both the full cohort study and the propensity score-matched study.
本研究旨在探讨前列腺癌患者去势治疗与心力衰竭之间的关系。这项队列研究使用了来自台湾 2005 年长期健康保险数据库的数据。在全队列研究中，我们确定了 1244 名接受去势治疗的前列腺癌患者作为研究队列，以及 1806 名未接受去势治疗的前列腺癌患者作为对照组。为了消除潜在的偏倚，我们进行了倾向评分匹配的队列研究。每位前列腺癌患者从索引日期开始随访 1 年，以确定他们是否随后被诊断为心力衰竭。在全队列研究中，1 年随访期间去势治疗组心力衰竭的发生率为每 100 人年 4.00（95%CI，2.95-5.30），而非去势治疗组为 1.89（95%CI，1.30-2.66）。此外，多变量 Cox 回归表明，与非去势治疗组相比，去势治疗组心力衰竭的风险比（HR）为 1.72（95%CI，1.08-2.73）。在倾向评分匹配的队列研究中，去势治疗组心力衰竭的调整 HR 为 1.92（95%CI，1.15-3.18），与倾向评分匹配的非使用者相比。总之，本研究发现，在全队列研究和倾向评分匹配研究中，与非使用者相比，去势治疗的前列腺癌患者心力衰竭的风险更高。
