Hypercholesterolemia and Diabetes Have Little Impact on Major Adverse Cardiovascular Events Risk in Patients With Prostate Cancer

Hypercholesterolemia and diabetes have a minimal impact on major adverse cardiovascular events (MACE) risk in patients with prostate cancer (PCa) who are treated with androgen deprivation therapy (ADT), according to research presented at the 48th Oncology Nursing Society (ONS) Congress in San Antonio, Texas.¹

Although patients with PCa treated with ADT potentially experience MACE, the extent to which MACE is caused by ADT remains unclear. And while high cholesterol was found to lower MACE risk on older men,² diabetes increases the risk of cardiovascular (CV) disease.³ Torres and colleagues aimed to determine whether there is an association between hypercholesterolemia/diabetes and MACE risk after ADT initiation in patients with PCa.

The research, which was conducted using data from medical records of more than 45,000 patients with PCa receiving luteinizing hormone-releasing hormone (LHRH) agonist/antagonist injections from 2010 to 2020, found that MACE risk was only 1.8% lower after 4 years for patients with hypercholesterolemia compared with those without. Additionally, MACE risk was found to be similar for patients with and without diabetes.

MACE was defined as myocardial infarction, stroke, and death from any cause.

The study results suggest that the slightly lower MACE risk in the patients with hypercholesterolemia may be due to the use of statins, which can reduce the incidence of CV events in the general population.

Overall, the study's results emphasize the importance of monitoring and managing CV health in patients with PCa receiving ADT, particularly in those with underlying CV risk factors.

It is recommended that heath care providers “monitor PCa patients with underlying CV risk factors and help educate them on lifestyle changes that could impact treatment outcomes,” according to the researchers.

References:

1. Torres L, Boldt-Houle DM, Atkinson, SN. Major adverse cardiovascular events after androgen deprivation therapy in prostate cancer patients with hypercholesterolemia/ diabetes. Poster presented at: 48th ONS Congress Meeting; April 26 – 30, 2023; San Antonio, TX. Accessed April 17, 2023. https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/13117
2. Gnanenthiran SR, Ng ACC, Cumming R, et al. Low total cholesterol is associated with increased major adverse cardiovascular events in men aged ≥70 years not taking statins. Heart. 2020;106(9):698-705. doi:10.1136/heartjnl-2019-315449
3. Sarwar N, Gao P, Seshasai SR, et al; Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215-2222. doi:10.1016/S0140-6736(10)60484-9