Abstract
Background:
Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.
Methods:Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher’s exact test was used for comparison of categorical variables.
Results:A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk.
Conclusions:PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Details
1 Department of Urology, Peking University People’s Hospital, Beijing 100044, China
2 Department of Clinical Epidemiology and Biostatistics, Peking University People’s Hospital, Beijing 100044, China
3 Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100005, China; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100005, China
4 Department of Urology, Wuhan Union Hospital, Huazhong University of Science & Technology, Wuhan, Hubei 430022, China
5 Department of Urology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan 610014, China
6 Department of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
7 Department of Urologic Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
8 Department of Urology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; National Cancer Center, Beijing 100021, China; National Clinical Research Center for Cancer, Beijing 100021, China
9 Department of Urology, Liaoning Cancer Hospital, Shenyang, Liaoning 110801, China
10 Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300141, China; Tianjin Institute of Urology, Tianjin Medical University, Tianjin 300141, China
11 Department of Urology, Lu’an Affiliated Hospital of Anhui Medical University, Lu’an, Anhui 237322, China
12 Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
13 Department of Urology, Harbin Medical University Affiliated Cancer Hospital, Harbin, Heilongjiang 150081, China
14 Department of Urology, The Second Hospital of Dalian Medical University, Dalian, Liaoning 116023, China
15 Department of Urology Surgery, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
16 Department of Urology Surgery, Hunan Cancer Hospital, Changsha, Hunan 410031, China
17 Department of Urology Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350004, China