Cáncer de próstata, terapia antiandrogénica y riesgo cardiovascular / Prostate cancer, antiandrogen treatment and cardiovascular risk

Objetivo: Comprobar si las tablas de riesgo cardiovascular (RCV) habitualmente empleadas soncapaces de identificar el incremento de riesgo producido por la terapia de bloqueo androgénico(BA) en los pacientes con cáncer de próstata (CP).Diseño: Estudio de cohortes retrospectivo.Emplazamiento: Centros de salud urbanos y rurales de la provincia de Ourense.Participantes: Pacientes diagnosticados de CP que tenían prescrito tratamiento de BA entre losaños 2007 y 2008.Mediciones principales: Se registró edad, residencia (rural/urbana), estadificación (Gleason),procedimiento diagnóstico y, al comienzo y fin del seguimiento, perfil lipídico, presión arterial,diagnóstico de diabetes mellitus, tabaquismo, uso de fármacos hipotensores e hipolipemiantes,e índices Framingham calibrado y ATP III. Se registraron los eventos cardiovasculares (ECV) alo largo del seguimiento. Cada paciente fue su propio control. Para calcular los índices al finaldel período no se consideró el incremento de edad. Los índices se compararon utilizando la tde Student para muestras apareadas (SPSS 15.0).Resultados: Se incluyeron 209 casos. La media (DE) de edad fue de 73,8 (8,0) años, con un 64,6%de casos urbanos. Los índices al inicio y a los 12 meses de seguimiento fueron: Framingham 9,0(4,6) y 9,2 (4,8) (p = 0,5); ATP III 14,2 (1,7) y 14,2 (1,7) (p = 0,9).Conclusión: Las tablas de RCV no permiten valorar adecuadamente el incremento del riesgoasociado a la terapia de bloqueo androgénico en cáncer de próstata(AU)

Aim: To assess if cardiovascular risk (CVR) charts are able to identify the increased risk causedby androgen deprivation therapy (ADT) in patients with prostate cancer (PCa).Design: Retrospective cohort study.Location: Urban and rural health centres in the province of Ourense.Participants: Patients diagnosed with PCa who had been prescribed treatment for ADT between2007 and 2008.Main measures: Age, residence (rural/urban), staging (Gleason), diagnostic procedure and, atthe beginning and end of follow-up, lipid profile, blood pressure, diagnosis of diabetes mellitus,smoking, use of antihypertensive and lipid-lowering drugs, and Framingham calibrated and ATPIII indexes, were determined. Cardiovascular events were recorded during the follow-up. Eachpatient was his own control. Increasing age was not used in the calculation of the scores atthe end of the follow up period. The scores were compared using the t-test for paired samples(SPSS 15.0).Results: A total of 209 cases were included. The mean (SD) age was 73.8 (8.0) years, with 64.6%of urban cases. The scores at baseline and at 12 months of follow-up were: Framingham 9.0(4.6) and 9.2 (4.8) (P = 0.5), ATP III 14.2 (1.7) and 14.2 (1.7) (P = 0.9).Conclusion: CVR charts do not assess the increased risk associated with androgen deprivationtherapy in prostate cancer(AU)

[Prostate cancer, antiandrogen treatment and cardiovascular risk]. / Cáncer de próstata, terapia antiandrogénica y riesgo cardiovascular.

AIM: To assess if cardiovascular risk (CVR) charts are able to identify the increased risk caused by androgen deprivation therapy (ADT) in patients with prostate cancer (PCa). DESIGN: Retrospective cohort study. LOCATION: Urban and rural health centres in the province of Ourense. PARTICIPANTS: Patients diagnosed with PCa who had been prescribed treatment for ADT between 2007 and 2008. MAIN MEASURES: Age, residence (rural/urban), staging (Gleason), diagnostic procedure and, at the beginning and end of follow-up, lipid profile, blood pressure, diagnosis of diabetes mellitus, smoking, use of antihypertensive and lipid-lowering drugs, and Framingham calibrated and ATP III indexes, were determined. Cardiovascular events were recorded during the follow-up. Each patient was his own control. Increasing age was not used in the calculation of the scores at the end of the follow up period. The scores were compared using the t-test for paired samples (SPSS 15.0). RESULTS: A total of 209 cases were included. The mean (SD) age was 73.8 (8.0) years, with 64.6% of urban cases. The scores at baseline and at 12 months of follow-up were: Framingham 9.0 (4.6) and 9.2 (4.8) (P=0.5), ATP III 14.2 (1.7) and 14.2 (1.7) (P=0.9). CONCLUSION: CVR charts do not assess the increased risk associated with androgen deprivation therapy in prostate cancer.