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    New data: ADT does not increase cardiovascular death risk


    Contrary to the conclusions of recent research, androgen deprivation therapy (ADT) does not appear to raise the risk of fatal heart attacks in men being treated for prostate cancer, according to a study published in JAMA.

    The multicenter study’s authors, led by Paul Nguyen, MD, and Toni Choueiri, MD, of Dana-Farber/Brigham and Women’s Cancer Center, Boston, conducted a meta-analysis of randomized studies involving 4,141 prostate cancer patients. The analysis found no difference in the rate of cardiovascular deaths in men receiving ADT compared with those who didn’t. The study could not rule out that ADT might elevate the risk of fatal heart attacks in patients with a history of heart disease, and the authors said they plan to look more closely at that population.

    "This message should be reassuring for the vast majority of patients considering androgen deprivation therapy," Nguyen said. "If you need ADT for your prostate cancer, go ahead and have it. Hormones can save lives."

    Most of the patients enrolled in the 8 randomized trials in the meta-analysis had locally advanced prostate cancer that had spread beyond the prostate gland. The authors found that cardiovascular deaths occurred in 11% of the patients who underwent ADT versus 11.2% in the control patients. All-cause mortality in the treated patients was 37.7% compared with 44.4% in the control group.

    The remaining question, according to Choueiri, is whether ADT might increase risk in men with an established history of previous heart disease, but those data were not available.

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