Effect of Androgen Deprivation Therapy on Metabolic Complications and Cardiovascular Risk

J Cardiovasc Transl Res. 2020 Jun;13(3):451-462. doi: 10.1007/s12265-019-09942-w. Epub 2019 Dec 12.

Abstract

Androgen deprivation therapy (ADT) has been the cornerstone of prostate cancer treatment. ADT delays cancer progression, alleviates cancer-related symptoms, and is associated with survival gains. Despite these established benefits, the extended duration of therapy comes with known side effects. Furthermore, research from the past decade has generated increased awareness for more potentially lethal cardiometabolic consequences of ADT. In this review, we explore the relationship between ADT and cardiometabolic effects. Current literature on this complex relationship remains conflicting, due to a variety of factors, including study design (randomized vs. observational), treatment decision-making, and patient factors. Looking to the future, a combination of well-designed, randomized controlled trials and high-quality, real-world evidence are needed to definitely establish any ADT cardiovascular safety signal and to evaluate the efficacy of potential screening and therapeutic interventions. Furthermore, a collaborative, integrated approach among all health care professionals is critical to accurately delineate patients' potential risk/benefit treatment options.

Keywords: Androgen deprivation therapy; Cardiovascular comorbidities; Cardiovascular morbidity; Myocardial infarction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Androgen Antagonists / adverse effects*
  • Animals
  • Cancer Survivors*
  • Cardiotoxicity
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / therapy
  • Humans
  • Male
  • Metabolic Diseases / chemically induced*
  • Metabolic Diseases / diagnosis
  • Metabolic Diseases / mortality
  • Metabolic Diseases / therapy
  • Prognosis
  • Prostatic Neoplasms / drug therapy*
  • Risk Assessment
  • Risk Factors

Substances

  • Androgen Antagonists