MP52-17 CARDIOVASCULAR EVENTS AND BIOMARKERS IN A RANDOMIZED TRIAL COMPARING LHRH AGONIST AND ANTAGONIST AMONG PATIENTS WITH ADVANCED PROSTATE CANCER Article Swipe

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III1 Apr 2018MP52-17 CARDIOVASCULAR EVENTS AND BIOMARKERS IN A RANDOMIZED TRIAL COMPARING LHRH AGONIST AND ANTAGONIST AMONG PATIENTS WITH ADVANCED PROSTATE CANCER David Margel, Avivit Pe'er, Yaara Ber, Marina Shaparberg, Sivan Sela, Rachel Ozalvo, Tzlil Tabachnik, Wilhelmina Duivenvoorden, Jehonathan Pinthus, and Jack Baniel David MargelDavid Margel More articles by this author , Avivit Pe'erAvivit Pe'er More articles by this author , Yaara BerYaara Ber More articles by this author , Marina ShaparbergMarina Shaparberg More articles by this author , Sivan SelaSivan Sela More articles by this author , Rachel OzalvoRachel Ozalvo More articles by this author , Tzlil TabachnikTzlil Tabachnik More articles by this author , Wilhelmina DuivenvoordenWilhelmina Duivenvoorden More articles by this author , Jehonathan PinthusJehonathan Pinthus More articles by this author , and Jack BanielJack Baniel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1668AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Androgen-deprivation therapy (ADT) used in prostate cancer patients may increase their risk of cardio-vascular events. Recent data suggests that LHRH-antagonist may be associated with lower risk of these events compared to LHRH-agonist. Our laboratory data suggest a role for FSH in mediating ADT induced atherosclerosis. We now report biomarkers of cardio-vascular events and outcomes from a randomized controlled study. METHODS A bicenteral randomized open-label study of the use of Degarelix compared to LHRH agonists among prostate cancer patients with pre-existing cardiovascular disease with scheduled to start ADT for at least a year. A Cardiovascular event was considered one of the following: myocardial infarction, ischaemic or haemorrhagic cerebrovascular event, arterial embolic and thrombotic events, emergency room visit or hospitalization due to ischaemic heart disease conditions, coronary artery or iliofemoral artery revascularization (percutaneous or surgical procedures), peripheral vascular disease event (vascular surgery/intervention). These events were prospectively collected. Serum levels for hormonal profile and biomarkers including NT-proBNP, D-Dimer, HS-Troponin and CRP were taken at baseline and every three months. RESULTS Eighty patients were enrolled (39 randomized to antagonist and 41 agonist), with a median follow up of 10 months. No difference in age, stage of prostate cancer and baseline cardiovascular were observed between the two arms. During follow-up 14 patients developed a new cardio-vascular event. Eight of the 14 patients were hospitalized due to ischemic heart disease, one patient suffered from a myocardial infarction and two from a new ischemic cerebrovascular event. Twenty-eight percent (n=11) of patients randomized to LHRH agonist had a cardiovascular event compared to 7% ( n=3) of those randomized to antagonists ( log rank p=0.008).Baseline levels of serum NT-proBNP, a well-known cardiac biomarker, was able to predict events (AUC= 0.69 95%CI 0.56-0.84 p=0.003). However baseline D-Dimer, HS-Troponin and CRP were not predictive. In addition patients with less than a 60% decrease in FSH levels during the first three months of treatment had a higher risk of developing a cardiovascular event ( 40% Vs 10%, p=0.005). CONCLUSIONS Our pilot study suggests that cardio-vascular events may develop early in patients receiving LHRH-agonist compared to antagonist. Baseline NT-proBNP may predict cardiovascular outcome. These events may be linked to reduce suppression of FSH during ADT. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e702 Advertisement Copyright & Permissions© 2018MetricsAuthor Information David Margel More articles by this author Avivit Pe'er More articles by this author Yaara Ber More articles by this author Marina Shaparberg More articles by this author Sivan Sela More articles by this author Rachel Ozalvo More articles by this author Tzlil Tabachnik More articles by this author Wilhelmina Duivenvoorden More articles by this author Jehonathan Pinthus More articles by this author Jack Baniel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...