C Tschöpe1,2,3, B Kherad4, F Spillmann4, C A Schneider5, B Pieske4,6,7, F Krackhardt4. 1. Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland. Carsten.tschoepe@charite.de. 2. Berliner Zentrum für Regenerative Therapien (BCRT), Campus Virchow-Klinikum (CVK), Berlin, Deutschland. Carsten.tschoepe@charite.de. 3. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Charité Berlin, Berlin, Deutschland. Carsten.tschoepe@charite.de. 4. Abteilung für Kardiologie, Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Deutschland. 5. Kardiologie an der PAN-Klinik, Köln, Deutschland. 6. Deutsches Herzzentrum, Berlin, Deutschland. 7. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Charité Berlin, Berlin, Deutschland.
Abstract
BACKGROUND: Several studies have indicated that reduction of testosterone levels in patients with prostate cancer undergoing androgen deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists can be associated with an increased risk of cardiovascular events. The GnRH antagonists have a different mode of action compared with GnRH agonists and may be preferred in ADT for patients with cardiovascular disease. OBJECTIVE: This review article discusses potential mechanisms underlying the development of cardiovascular events associated with ADT when using GnRH agonists and explains the differences in mode of action between GnRH agonists and GnRH antagonists. Additionally, relevant studies are presented and practical recommendations for the clinical practice are provided. MATERIAL AND METHODS: A literature search was performed. Full publications and abstracts published in the last 10 years up to September 2015 were considered to be eligible. RESULTS: The GnRH antagonists were associated with a decreased risk of cardiovascular events compared with GnRH agonists in prostate cancer patients undergoing ADT and particularly in patients with cardiovascular risk factors or a history of cardiovascular disease. This decrease may be due to the different mode of action of GnRH antagonists compared with GnRH agonists. CONCLUSION: Prostate cancer patients with either cardiovascular disease or an increased risk of experiencing a cardiovascular event undergoing ADT should be preferentially treated with GnRH antagonists.
BACKGROUND: Several studies have indicated that reduction of testosterone levels in patients with prostate cancer undergoing androgen deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists can be associated with an increased risk of cardiovascular events. The GnRH antagonists have a different mode of action compared with GnRH agonists and may be preferred in ADT for patients with cardiovascular disease. OBJECTIVE: This review article discusses potential mechanisms underlying the development of cardiovascular events associated with ADT when using GnRH agonists and explains the differences in mode of action between GnRH agonists and GnRH antagonists. Additionally, relevant studies are presented and practical recommendations for the clinical practice are provided. MATERIAL AND METHODS: A literature search was performed. Full publications and abstracts published in the last 10 years up to September 2015 were considered to be eligible. RESULTS: The GnRH antagonists were associated with a decreased risk of cardiovascular events compared with GnRH agonists in prostate cancerpatients undergoing ADT and particularly in patients with cardiovascular risk factors or a history of cardiovascular disease. This decrease may be due to the different mode of action of GnRH antagonists compared with GnRH agonists. CONCLUSION:Prostate cancerpatients with either cardiovascular disease or an increased risk of experiencing a cardiovascular event undergoing ADT should be preferentially treated with GnRH antagonists.
Authors: Marianne Schmid; Jesse D Sammon; Gally Reznor; Victor Kapoor; Jacqueline M Speed; Firas A Abdollah; Akshay Sood; Felix K-H Chun; Adam S Kibel; Mani Menon; Margit Fisch; Maxine Sun; Quoc-Dien Trinh Journal: BJU Int Date: 2015-07-22 Impact factor: 5.588
Authors: Marie C Hupe; Peter Hammerer; Miriam Ketz; Nils Kossack; Christiane Colling; Axel S Merseburger Journal: Front Oncol Date: 2018-11-27 Impact factor: 6.244