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前列腺癌中的心血管风险。

Cardiovascular Risk in Prostate Cancer.

机构信息

Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada.

Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada.

出版信息

Cardiol Clin. 2025 Feb;43(1):83-91. doi: 10.1016/j.ccl.2024.09.003. Epub 2024 Oct 5.

Abstract

Cardiovascular disease is common in patients with prostate cancer and is an important cause of death. Cardiovascular risk factors are frequent in this population and are often not addressed to thresholds recommended by cardiovascular practice guidelines. Androgen deprivation therapy (ADT) reduces muscle strength and increases adiposity, thereby increasing the risk of diabetes and hypertension, although its relationship with adverse cardiovascular events requires confirmation. Androgen receptor signaling inhibitors and CYP17A1 inhibitors may confer incremental risks of hypertension and cardiovascular events to ADT. Lower cardiovascular risk with gonadotropin-releasing hormone antagonists as compared with agonists requires prespecified randomized clinical trial confirmation.

摘要

心血管疾病在前列腺癌患者中很常见,也是导致死亡的一个重要原因。该人群中常存在心血管危险因素,但往往未达到心血管实践指南推荐的阈值。去势治疗(ADT)会降低肌肉力量并增加脂肪量,从而增加糖尿病和高血压的风险,尽管其与不良心血管事件的关系仍有待证实。雄激素受体信号抑制剂和 CYP17A1 抑制剂可能会增加 ADT 的高血压和心血管事件风险。与激动剂相比,促性腺激素释放激素拮抗剂具有更低的心血管风险,但这需要预先设定的随机临床试验来证实。

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