Association of Gonadotropin-Releasing Hormone Therapies With Venous Thromboembolic Events in Patients With Prostate Cancer: A National Cohort Study

Frontiers in Cardiovascular Medicine

article

Chon-Seng Hong¹  Yi-Chen Chen²  Chung-Han Ho²  Kun-Lin Hsieh⁴  Michael Chen¹  Jhih-Yuan Shih¹  Chun-Yen Chiang¹  Zhih-Cherng Chen¹  Wei-Ting Chang¹ 

[1] Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center;Department of Medical Research, Chi-Mei Medical Center;Department of Information Management, Southern Taiwan University of Science and Technology;Division of Urology, Department of Surgery, Chi-Mei Medical Center;Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University;Department of Health and Nutrition, Chia Nan University of Pharmacy and Science;Department of Optometry, Chung Hwa University of Medical Technology;Department of Biotechnology, Southern Taiwan University of Science and Technology;College of Medicine, Institute of Clinical Medicine, National Cheng Kung University

关键词: prostate cancer;    GnRH therapies;    androgen deprivation therapies;    venous thromboembolic events;    age;    cancer stage;   

DOI  :  10.3389/fcvm.2022.794310

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Although androgen deprivation therapy (ADT) has been proposed to be associated with a higher risk of venous thromboembolisms (VTEs), whether gonadotropin-releasing hormones (GnRHs), such as both agonists and antagonists, are also associated with VTEs remain unclear. Using the Taiwan Cancer Registry (TCR) linked with the National Health Insurance Research Database, we identified patients diagnosed with prostate cancer from 2008 to 2015. Patients who received GnRH were 1:1 propensity score matched with non-GnRH users by age and cancer stage at diagnosis and clinical stage. Cox regression analysis was applied to estimate the incidences of VTEs with death as a competing event at the 5-year follow-up. The VTE incidence among GnRH users was 1.13% compared with 0.98% among non-users. After adjusting with potential confounding factors, the risk of VTEs showed borderline statistical significance among GnRH users and non-users. Notably, in the subgroup analysis among patients receiving GnRH therapy, those younger than 70 years old or at an earlier stage (stage I/II) were at a higher risk of VTEs. Different from previous studies, our findings highlighted critical concerns regarding the cardiac safety of GnRH therapies in prostate cancer patients at a relatively younger age or at an earlier stage.

【 授权许可】

CC BY