Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2020 Feb 3;35(4):e47. doi: 10.3346/jkms.2020.35.e47.
The objective of this study was to investigate whether androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonist (GnRHa) in prostate cancer (Pca) patients is associated with cardiovascular disease in the cohort based from the entire Korean population.
Using the Korean National Health Insurance database, we conducted an observational study of 579,377 men who sought treatment for Pca between January 1, 2012 and December 31, 2016. After excluding patients with previously diagnosed cardiovascular disease or who had undergone chemotherapy, we extracted the data from 2,053 patients who started GnRHa (GnRHa users) and 2,654 men who were newly diagnosed with Pca (GnRHa nonusers) between July 1, 2012, and December 31, 2012, with follow-up through December 31, 2016. The primary outcomes were cerebrovascular attack (CVA) and ischemic heart disease (IHD).
GnRHa users were older, were more likely to reside in rural areas, had lower socioeconomic status, and had more comorbidities than nonusers (all < 0.050). Although GnRHa users had an increased incidence of CVA and IHD ( = 0.013 and 0.048, respectively) in univariate analysis, GnRHa use was not associated with the outcomes in multivariate analysis. Furthermore, the cumulative duration of ADT was not associated with the outcomes whereas the associations between age at diagnosis with all diseases were significant.
Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.
本研究旨在探讨前列腺癌（Pca）患者接受促性腺激素释放激素激动剂（GnRHa）的雄激素剥夺疗法（ADT）是否与整个韩国人群队列中的心血管疾病相关。
我们使用韩国国家健康保险数据库，对 2012 年 1 月 1 日至 2016 年 12 月 31 日期间寻求 Pca 治疗的 579377 名男性进行了一项观察性研究。排除有先前诊断的心血管疾病或接受过化疗的患者后，我们从 2012 年 7 月 1 日至 2012 年 12 月 31 日期间开始使用 GnRHa（GnRHa 用户）的 2053 名患者和新诊断为 Pca（GnRHa 非使用者）的 2654 名男性中提取数据，随访至 2016 年 12 月 31 日。主要结局为脑血管意外（CVA）和缺血性心脏病（IHD）。
GnRHa 用户年龄较大，更可能居住在农村地区，社会经济地位较低，合并症更多（均<0.050）。尽管在单变量分析中，GnRHa 用户的 CVA 和 IHD 发生率增加（分别为=0.013 和 0.048），但多变量分析中 GnRHa 使用与结局无关。此外，ADT 的累积持续时间与结局无关，而诊断时的年龄与所有疾病之间的关联均具有统计学意义。
我们对韩国 Pca 人群的全面分析表明，ADT 与心血管疾病风险增加无关。
