The prevalence of cardiac risk factors in men with localized prostate cancer undergoing androgren deprivation therapy in British Columbia, Canada.

Abstract

e16086 Background: While androgen deprivation therapy (ADT) decreases the risk of prostate cancer specific mortality in high risk localized prostate cancer treated with radiotherapy, it worsens cardiovascular (CV) risk factor profiles in treated men. Patients with pre-existing traditional cardiac risk factors who are treated with ADT have a higher rate of CV mortality than patients without risk factors. Methods: We retrospectively reviewed the charts of the last 100 consecutive men with intermediate or high risk localized prostate cancer who were referred to the British Columbia Cancer Agency from October 1, 2011 to October 31, 2012 and treated with ADT. Inclusion criteria were referral to an oncologist within 3 months of diagnosis and a planned duration of ADT of 6 month or more. Patients with metastatic prostate cancer at diagnosis were excluded. Data on traditional cardiac risk factors were collected and a Framingham risk score was calculated on each patient to estimate their 10 year cardiac event risk. Results: The average age of the men referred for ADT was 71.7±7 years. Most, 70%, had poorly differentiated disease and the PSA was >10ug/L in 62%. An updated Charlson score of 0 was calculated in 82% of patients; only 4% had a score ≥2. The Framingham risk of a cardiac event in the next 10 years was calculated to be high (more than 20% risk) in 69%, intermediate (a 10-20% risk) in 30%, and low (<10% risk) in 1% of the patients. A history of coronary artery disease was present in 17 patients, 11 of whom had documented revascularization. Baseline type 2 diabetes or impaired glucose tolerance was present in 24 patients, and 58 patients had a history of hypertension. Lipid profiles had been measured within the past year in 38 patients, and 35 patients had a baseline ECG on the chart. Conclusions: Given the high prevalence of cardiac risk factors in men with prostate cancer referred for ADT, we recommend baseline cardiac risk screening of lipids, blood glucose, and blood pressure in these patients with subsequent close monitoring of these parameters while on ADT. Among those individuals with established or symptomatic CV disease, we recommend referral to a specialist with expertise in cardiology.