Cardiovascular Comorbidities Do Not Impact Prostate Artery Embolisation (PAE) Outcomes: Retrospective Analysis of the National UK-ROPE Registry

Cardiovasc Intervent Radiol. 2024 Jan;47(1):115-120. doi: 10.1007/s00270-023-03608-6. Epub 2023 Nov 27.

Abstract

Purpose: Prostate artery embolisation (PAE) is a key treatment for the management of symptomatic benign prostatic hyperplasia (BPH). Common cardiovascular risk factors might be associated with suboptimal outcomes and thus influence patient treatment selection. The aim of the study was to evaluate whether cardiovascular comorbidities affect PAE outcomes.

Methods: Retrospective subset analysis of the UK Registry of Prostate Artery Embolisation (UK-ROPE) database was performed with patients who had a full documented past medical histories including hypertension, diabetes, coronary artery disease (CAD), diabetes and smoking status as well as international prostate symptom score (IPSS) at baseline and at 12 months. Multiple regression was performed to assess for any significant predictors.

Results: Comorbidity data were available for 100/216 patients (mean age 65.8 ± 6.4 years), baseline IPSS 20.9 ± 7.0). Regression analysis revealed that the presence of hypertension (53.7% IPSS reduction vs. absence 51.4%, p = 0.94), diabetes (52.6% vs. absence 52.1%, p = 0.6), CAD (59.2% vs. absence 51.4%, p = 0.95), no comorbidities (49.8% vs. any comorbidity present 55.3%, p = 0.66), smoking status (non-smoker, 52.6%, current smoker, 61.5%, ex-smoker, 49.8%, p > 0.05), age (p = 0.52) and baseline Qmax (p = 0.41) did not significantly impact IPSS reduction at 12 months post-PAE. Baseline prostate volume significantly influenced IPSS reduction (≥ 80 cc prostates, 58.9% vs. < 80 cc prostates 43.2%, p < 0.05).

Conclusion: The presence of cardiovascular comorbidities/smoking history does not appear to significantly impact PAE symptom score outcomes at 12 months post procedure. Our findings suggest that if the prostatic artery can be accessed, then clinical success is comparable to those without cardiovascular comorbidities.

Keywords: Benign prostatic hyperplasia (BPH); Cardiovascular risk; Diabetes; Hypertension; Lower urinary tract symptoms (LUTS); Prostate artery embolisation (PAE); Smoking.

MeSH terms

  • Aged
  • Arteries
  • Comorbidity
  • Diabetes Mellitus*
  • Embolization, Therapeutic* / methods
  • Humans
  • Hypertension* / etiology
  • Infant, Newborn
  • Lower Urinary Tract Symptoms* / therapy
  • Male
  • Middle Aged
  • Prostate / blood supply
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / epidemiology
  • Prostatic Hyperplasia* / therapy
  • Quality of Life
  • Registries
  • Retrospective Studies
  • Treatment Outcome
  • United Kingdom / epidemiology