MP24-19 TYPE OF ANDROGEN DEPRIVATION THERAPY AND THE RISK OF CARDIOVASCULAR DISEASES IN PATIENTS WITH PROSTATE CANCER WITH OR WITHOUT PRE-EXISTING CARDIOVASCULAR RISK
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) II (MP24)1 Sep 2021MP24-19 TYPE OF ANDROGEN DEPRIVATION THERAPY AND THE RISK OF CARDIOVASCULAR DISEASES IN PATIENTS WITH PROSTATE CANCER WITH OR WITHOUT PRE-EXISTING CARDIOVASCULAR RISK Alice Dragomir, Nawar Touma, and Armen Aprikian Alice DragomirAlice Dragomir More articles by this author , Nawar ToumaNawar Touma More articles by this author , and Armen AprikianArmen Aprikian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002015.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Controversies exist regarding the risk of cardiovascular events in prostate cancer patients treated with androgen deprivation therapy (ADT). We sought to evaluate the association between gonadotropin-releasing hormone (GnRH) agonists versus GnRH antagonist (Degarelix) and the risk of cardiovascular disease (CVD) in patients with prostate cancer with or without prior CVD. METHODS: Using administrative databases from the province of Quebec in Canada, we identified patients initiating androgen deprivation therapy (ADT) between Jan 2012 and June 2016. Two groups of patients were defined based on the type of ADT received at the 1st prescription: GnRH agonists and Degarelix groups. To be included, patients had to be new users of ADT. The end of follow-up was the date of the first CVD (myocardial infarction (MI), stroke, ischemic heart disease (IHD), arrhythmia and heart failure (HF)), switch of GnRH group, death or Dec 13, 2016. The inverse probability of treatment weighting (IPTW) based on propensity score was used to reduce the effect of potential confounding. IPTW-Cox proportional hazard model for competing risk was used to evaluate the association between the exposure to GnRH agonists or antagonist, and the risk of CVD. RESULTS: This study cohort consists of 10,785 patients: 10,201 initiating GnRH agonists and 584 initiating Degarelix. Mean age was 75 years old, similar between groups. A total of 3,304 (32.4%) and 236 (40.4%) men had CVD in the year prior to ADT initiation, in GnRH agonists and antagonist groups, respectively. A decreased risk of MI, stroke and HF was observed in Degarelix group, yet the Hazard ratios (HR) were not significant (HR: 0.63; 95% confidence interval (CI) 0.37-1.07, HR: 0.76; 95%CI 0.42-1.37 and HR: 0.64; 95%CI 0.41-1.00, respectively). But, an increased risk of arrhythmia was observed (HR:1.46; 95%CI 1.18-1.81) in Degarelix group when compared to the GnRH agonist group. CONCLUSIONS: Degarelix was found to be associated with the risk of developing arrhythmia compared to GnRH agonists in patients with prostate cancer regardless of pre-existing cardiovascular risk. Yet, it might be associated with a decreased risk for other CVDs in this population. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e419-e419 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alice Dragomir More articles by this author Nawar Touma More articles by this author Armen Aprikian More articles by this author Expand All Advertisement Loading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".